A Systematic Review And Meta-Analysis Comparing The Prognoses Of Benign Thyroid Nodules Using Radiofrequency Ablation Versus Lobectomy

Abstract

BACKGROUND: The evolution of technology and medicine has allowed for a considerable number of alternatives for treating medical issues, particularly those requiring invasive surgery. Thyroid nodules consisting of abnormal benign tissue are conventionally managed with surgery (lobectomy); however, advancements have introduced radiofrequency ablation as a method to manage these nodules. The two interventions have shown similar efficacies and no conclusive determination has been reported that proves which method (if any) has the lower recurrence rate. Therefore, this systematic review and meta-analysis was designed to fill this information gap. MATERIALS AND METHODS: Articles were selected based on eligible criteria and the PRISMA algorithm using the electronic databases PubMed, Science Direct, and Europe PMC and the PICO terms "radiofrequency ablation", "lobectomy", "benign thyroid nodule", and "recurrences". Eligible studies were subsequently assessed using the risk bias criteria of the Quality Appraisal of Case Series Studies Checklist and processed with the BUGSnet package in R studio. The results were presented in Funnel and Forest plots. RESULTS: Of the 18 eligible studies, 14 involved radiofrequency ablation and 5 involved lobectomies. The recurrence rate using the lobectomy procedure was 11 % (95 % CI, 2-40 %), whereas that with radiofrequency ablation was 4 % (95 % CI, 2-10 %)(p-value < 0.05). Both intervention populations showed high heterogeneity (I2>60 %). CONCLUSIONS: The recurrence rate of radiofrequency ablation was lower compared to that of lobectomy; however, the high heterogeneity, low sample numbers, lack of direct comparison, and homogeneous design of the studies suggest that further testing is required to confirm this finding.

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