Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore 21287, MD, USA.
Department of Internal Medicine, Sinai Hospital, Baltimore 21215, MD, USA.
Am J Otolaryngol. 2022 Jan-Feb;43(1):103204. doi: 10.1016/j.amjoto.2021.103204. Epub 2021 Sep 10.
Thyroid nodules are commonly being diagnosed in general population and have a potential for malignant transformation. Historically, surgery has been considered as the first line treatment for these tumors. However, with passage of time newer minimally invasive techniques such as RFA (radiofrequency ablation) has been adapted. Though, RFA for thyroid tumors has been performed more commonly in Asian and European countries, it is a fairly new technique in North America. The aim of the review is to assess the current data and conclude that whether RFA is likely a valuable option when compared to surgery for treatment of thyroid tumors.
A Comprehensive PubMed/MEDLINE, Embase and Web of Science search was performed. To expand our search, references of the retrieved articles were also screened for additional data. After selecting the studies that fulfilled the initial screening, authors independently reviewed the selected studies and screened the full texts to identify those that met the inclusion criteria.
The comprehensive literature search from PubMed/MEDLINE, Web of Science, and EMBASE databases revealed 1094 studies (Embase 870, PubMed 200, and Web of Science 24). References were imported for screening. Amongst 1094 studies, 138 duplicates removed, and 956 studies were screened against title and abstract. After these 777 studies were excluded the remaining 179 studies were assessed for full-text eligibility. Amongst them 127 studies excluded due to wrong design or setting. Finally, 18 studies were included in the review.
RFA appears to be a safe alternative to surgery in selected cases. However, it is not widely used and there are few randomized controlled trials. Furthermore, it is associated with a low risk profile and has shown promising results in patients who are difficult surgery candidates. Currently large-scale prospective studies are needed in North America to establish the efficacy of RFA and its use as an alternative to surgery for thyroid tumors.
甲状腺结节在普通人群中被广泛诊断出来，并且具有恶性转化的潜在风险。历史上，手术被认为是这些肿瘤的首选治疗方法。然而，随着时间的推移，新的微创技术如射频消融（RFA）已经被采用。尽管 RFA 已在亚洲和欧洲国家更常用于甲状腺肿瘤，但在北美它仍是一种相当新的技术。本综述的目的是评估当前的数据，并得出结论，与手术相比，RFA 是否是治疗甲状腺肿瘤的一种有价值的选择。
进行了全面的 PubMed/MEDLINE、Embase 和 Web of Science 检索。为了扩大我们的搜索范围，还对检索到的文章的参考文献进行了筛选，以获取更多数据。在选择符合初始筛选标准的研究后，作者独立地对所选研究进行了审查，并筛选了全文，以确定符合纳入标准的研究。
从 PubMed/MEDLINE、Web of Science 和 EMBASE 数据库进行的全面文献检索共显示 1094 项研究（Embase 870 项、PubMed 200 项和 Web of Science 24 项）。导入了参考文献进行筛选。在 1094 项研究中，排除了 138 项重复研究，对 956 项研究的标题和摘要进行了筛选。在排除了这 777 项研究后，对其余的 179 项研究进行了全文评估。其中 127 项由于设计或设置不正确而被排除。最后，有 18 项研究被纳入综述。
RFA 在选定病例中似乎是手术的一种安全替代方法。然而，它尚未广泛应用，并且仅有少数随机对照试验。此外，它的风险低，并且在难以手术的患者中显示出有前景的结果。目前，北美需要进行大规模的前瞻性研究，以确定 RFA 的疗效及其作为甲状腺肿瘤手术替代方法的应用。
