Thyroid No Surgery 101: Radiofrequency Ablation is First Line Treatment for Benign Thyroid Nodules

Thyroid No Surgery 101: Radiofrequency Ablation is First Line Treatment for Benign Thyroid Nodules

Thyroid No Surgery 101: Radiofrequency Ablation is First Line Treatment for Benign Thyroid Nodules

Thyroid No Surgery 101: Radiofrequency Ablation RFA is First Line Treatment for Benign Thyroid Nodules not Surgery!

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No more unnecessary thyroid surgery for benign goiter nodules.

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Dr.Guttler’s comments on study:

  1. 200 had surgery and 200 had RFA.
  2. RFA reduced to nodules size.
  3. Complications were less with RFA.
  4. Hypothyroid was found in 70% with surgery and none with RFA.
  5. RFA did not need hospital visits.
  6. RFA is the treatment of choice for benign thyroid nodules.Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules.
  7. Call me for details for RFA treatment in my center.
  8. 310-393-8860 or email to thyroid.manager@protonmail.com.
  9. Dr.G

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Ultrasound of Typical nodule that responds well to RFA.

Treatment of Benign Thyroid Nodules: Comparison of Surgery with Radiofrequency Ablation

Y. Che et al

BACKGROUND AND PURPOSE: Nodular goiter is one of the most common benign lesions in thyroid nodule. The main treatment of the disease is still the traditional surgical resection, however there are many problems such as general anesthesia, surgical scar, postoperative thyroid or parathyroid function abnormalities, and high nodules recurrence rate in residual gland. The purpose of this study was to compare the efficacy, safety, and cost-effectiveness of 2 treatment methods, surgery and radiofrequency ablation, for the treatment of benign thyroid nodules.

MATERIALS AND METHODS: From May 2012 to September 2013, 200 patients with nodular goiters who underwent surgery (group A) and 200 patients treated by radiofrequency ablation (group B) were enrolled in this study. Inclusion criteria were the following: 1) cosmetic problem, 2) nodule-related symptoms, 3) hyperfunctioning nodules related to thyrotoxicosis, and 4) refusal of surgery (for group B). An internally cooled radiofrequency ablation system and an 18-ga internally cooled electrode were used. We compared the 2 groups in terms of efficacy, safety, and cost-effectiveness during a 1-year follow-up.

RESULTS: After radiofrequency ablation, the nodule volume decreased significantly from 5.4 to 0.4 mL (P = .002) at the 12-month follow-up. The incidence of complications was significantly higher from surgery than from radiofrequency ablation (6.0% versus 1.0%, P = .002). Hypothyroidism was detected in 71.5% of patients after surgery but in none following radiofrequency ablation. The rate of residual nodules (11.9% versus 2.9%, P = .004) and hospitalization days was significantly greater after surgery (6.6 versus 2.1 days, P < .001), but the cost difference was not significant.

CONCLUSIONS: Surgical resection and radiofrequency ablation are both effective treatments of nodular goiter. Compared with surgery, the advantages of radiofrequency ablation include fewer complications, preservation of thyroid function, and fewer hospitalization days. Therefore, radiofrequency ablation should be considered a first-line treatment for benign thyroid nodules.

1 Comment
  • Chuck August 9, 2019 3:01 pm

    Esteemed Dr. Guttler,
    Your radio ablation is interesting.
    You mention it for first line of defense treatment for benign tumors, however, is this something that could be considered as a first line treatment for a PTC that was diagnosed only based on the nucleus shape of a “scant” number of cells, and that showed negative to the 2 main mutation markers (BRAF and I dont know the name of the other one) ? I for one find such a diagnosis to my engineer’s brain rather subjective, and It would seem to me that, from what I read, the BRAF is the main indicator of PTC agressiveness , and with with the BRAF negative, it would be better to try the radio ablation FIRST, and if it does not work after say 8 weeks, only the go to surgery and remove that affected lobe. What do you think?

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