Microwave Ablation Versus Surgery for Thyroid Nodules

Patients treated with microwave ablation had significantly reduced nodule volume and fewer nodule-related symptoms than those treated with surgery, researchers reported. Recovery times were also quicker, outcomes were more satisfactory aesthetically, and cost was reduced compared with surgery.

Surgical treatment of symptomatic benign thyroid nodules has traditionally been standard of care, but microwave ablation is now a commonly used option. The current study aimed to determine the efficacy, tolerability, and cost of microwave ablation compared with surgery.

The investigators conducted a prospective study that included 52 patients with symptomatic benign thyroid nodules who were randomly assigned to treatment with microwave ablation or surgery. Results indicated that nodules treated with microwave ablation had a mean reduced nodule volume of 72.3% at 3 months, 84.5% at 6 months, and 92.4% at 12 months. During the 12-month follow-up, patients who underwent microwave ablation did not have thyroid dysfunction.

“Our data show that MWA can reduce thyroid nodule volume and alleviate nodule-related symptoms and cosmetic concerns as effectively as surgery,” the authors wrote.

Both surgery and microwave ablation were determined to be safe; however, fewer complications and rarer reports of pain were observed in patients who received microwave ablation. Furthermore, the group undergoing microwave ablation had superior length of stay, postoperative scar length, and operation time compared with the surgery group. General health and mental health scores at 6 and 12 months were also more improved in the microwave ablation group than in the surgery group.

The authors noted though, that surgery seems more effective than microwave ablation for patients with multiple nodules and that surgery may also facilitate obtaining conclusive pathologic results. Additionally, they acknowledged that the current study was limited by the small size and follow-up period of only 12 months.

“In conclusion, our comparative study shows that, for benign thyroid nodules, microwave ablation is an effective alternative to surgery, which may be undesirable in cases of limited local symptoms or cosmetic concerns. Microwave ablation can significantly reduce nodule volume and nodule-related symptoms with more rapid recovery, more pleasing esthetic outcomes, less physiologic disruption and less expense,” they stated.

—Lauren LeBano

Reference

Zhi X, Zhao N, Liu Y, Liu JB, Teng CS, Qian L. Microwave ablation compared to thyroidectomy to treat benign thyroid nodules. Int J Hyperthermia. 2018 Mar 26:1-31. doi: 10.1080/02656736.2018.1456677. [Epub ahead of print]