TY - JOUR
T1 - Radiofrequency Ablation and Autonomous Functioning Thyroid Nodules
T2 - Review of the Current Literature
AU - Muhammad, Haris
AU - Tehreem, Aniqa
AU - Russell, Jonathon O.
AU - Tufano, Ralph P.
N1 - Funding Information:
Statistical analysis by Dr Wang from ICTR (Institute for Clinical and Translational Research) which is funded by NIH (National Institute of Health) UL1 grant.
Publisher Copyright:
© 2021 The American Laryngological, Rhinological and Otological Society, Inc.
PY - 2022/4
Y1 - 2022/4
N2 - Objective: Autonomously functioning thyroid nodules (AFTNs) have long been treated with either surgery or radioactive iodine (RAI). Being an invasive procedure, even thyroid lobectomy for this condition is associated with complications such as anesthesia side effects, scarring, iatrogenic hypothyroidism, and injury to other structures. Similarly, RAI is associated with hypothyroidism and may require multiple courses. Therefore, minimally invasive techniques such as radiofrequency ablation (RFA) are being advocated as an alternative treatment for AFTNs. To date, only few studies have been published on this topic and are largely on European and Asian populations. The aim of this review is to assess the efficacy and safety of RFA as a potential alternative for treatment of AFTNs compared to conventional surgery and radioiodine. Methods/Study design: Comprehensive PubMed and Embase searches were performed using the following terms such as (autonomously functioning thyroid nodules and radiofrequency ablation), (radiofrequency ablation and hyperthyroidism), and (radiofrequency ablation and toxic thyroid nodule). Both prospective and retrospective studies were included based on the inclusion and exclusion criteria specified in the text. Results: Initially, 57 studies were identified and after excluding 47 studies, finally 10 studies were included in the review. Conclusion: Although surgery remains the first line treatment for AFTN. However, RFA is a safe option compared to RAI or surgery, especially in patients who are high-risk surgical candidates or have absolute contraindications to RAI. Currently, trials with follow-up greater than or equal to 5 years are warranted. It will aid in formulating a standardized surveillance protocol and also generalize RFA's use for AFTN. Laryngoscope, 132:906–914, 2022.
AB - Objective: Autonomously functioning thyroid nodules (AFTNs) have long been treated with either surgery or radioactive iodine (RAI). Being an invasive procedure, even thyroid lobectomy for this condition is associated with complications such as anesthesia side effects, scarring, iatrogenic hypothyroidism, and injury to other structures. Similarly, RAI is associated with hypothyroidism and may require multiple courses. Therefore, minimally invasive techniques such as radiofrequency ablation (RFA) are being advocated as an alternative treatment for AFTNs. To date, only few studies have been published on this topic and are largely on European and Asian populations. The aim of this review is to assess the efficacy and safety of RFA as a potential alternative for treatment of AFTNs compared to conventional surgery and radioiodine. Methods/Study design: Comprehensive PubMed and Embase searches were performed using the following terms such as (autonomously functioning thyroid nodules and radiofrequency ablation), (radiofrequency ablation and hyperthyroidism), and (radiofrequency ablation and toxic thyroid nodule). Both prospective and retrospective studies were included based on the inclusion and exclusion criteria specified in the text. Results: Initially, 57 studies were identified and after excluding 47 studies, finally 10 studies were included in the review. Conclusion: Although surgery remains the first line treatment for AFTN. However, RFA is a safe option compared to RAI or surgery, especially in patients who are high-risk surgical candidates or have absolute contraindications to RAI. Currently, trials with follow-up greater than or equal to 5 years are warranted. It will aid in formulating a standardized surveillance protocol and also generalize RFA's use for AFTN. Laryngoscope, 132:906–914, 2022.
KW - Radiofrequency ablation (RFA)
KW - autonomously functioning thyroid nodules (AFTNs)
KW - hypothyroidism
KW - radioiodine (RI)
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U2 - 10.1002/lary.29811
DO - 10.1002/lary.29811
M3 - Review article
C2 - 34375454
AN - SCOPUS:85112116250
SN - 0023-852X
VL - 132
SP - 906
EP - 914
JO - Laryngoscope
JF - Laryngoscope
IS - 4
ER -