10-Year Clinical Follow-up for RFA of Thyroid Nodules

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Lasting Relief: Outcomes Ten Years after Thyroid RFA

Radiofrequency ablation (RFA) is a non-surgical, outpatient technique that has been used to treat benign and malignant thyroid nodules for over 20 years.1-4 With advantages such as preservation of thyroid function, lower rates of pain and complications, and faster treatment and recovery times, RFA presents an excellent option for patients seeking a safe and effective alternative to thyroidectomy surgery. The technique appears most appropriate for cases where a single or dominant nodule has been confirmed benign and is clearly linked to compressive, cosmetic, or hyperthyroidism symptoms. Clinical evidence and guidelines are evolving for treatment of other types of nodules, including certain cancers like papillary thyroid microcarcinoma.4-6

Studies have established that RFA can reduce the size of benign thyroid nodules by 50-90% over the 6-12 months after treatment, and that size reduction and concomitant symptom reduction can endure for up to 5 years.4,5 Recently, several peer-reviewed publications have extended the clinical follow-up period after thyroid RFA to over 10 years. They document long-term outcomes of thyroid RFA treatment, including rates of nodular regrowth and subsequent surgery, in addition to rates of complications and nodular size reduction.7-9

Radiofrequency Ablation for the Treatment of Benign Thyroid Nodules: 10-Year Experience (Park et al. 2024)7

  • Retrospective evaluation of 456 benign nodules treated using RFA in 421 patients
  • Average nodule volume reduction:
    • 63% after 6 months
    • 81% after 2 years
    • 90% after 5 years
    • 94% after 10 years
  • Nodular regrowth rate: 12%, of which:
    • 62% had repeat RFA
    • 8% had surgery
    • 30% had observation only
    • Regrowth was more likely in larger (≥20 mL) than smaller (<10 mL) nodules
  • Delayed surgery rate: 6%, of which:
    • 15% due to nodular regrowth
    • 85% due to new tumors
    • Average time from RFA to surgery: 7.5 years
  • Complications rate: 2.4%, none severe or long-term
  • Conclusions:
    • RFA can produce safe, substantial, and durable nodule volume reduction over 10 years.
    • Regular follow-up is suggested due to possible nodular growth and later need for surgery.

Radiofrequency Ablation of Benign Thyroid Nodules: 10-Year Follow-Up Results From a Single Center (Shin et al. 2025)8

Retrospective evaluation of median volume reduction of 267 benign nodules treated using RFA in 237 patients

  • Single-session RFA:
    • 95.7% reduction after 5 years (n=28)
    • 98.8% reduction after 10 years (n=16)
    • Smaller nodules (<10 mL) were more prevalent in this group
  • Multi-session RFA:
    • 97.4% reduction after 5 years (n=32)
    • 96.9% reduction after 10 years (n=13)
  • Safety and Efficacy (n=267):
    • Nodular regrowth rate: 9.7%
    • Delayed surgery rate: 1.5%
    • Complications rate: 4.1% procedure related, 3.4% minor, 0.7% major
    • No serious disabilities or morbidities
  • Conclusions:
    • Single-session RFA can produce substantial and durable nodule size reduction over 10 years, particularly for smaller nodules.
    • For larger nodules, multiple RFA sessions may be required to achieve a large volume reduction.

Radiofrequency Ablation of Low-Risk Papillary Thyroid Microcarcinoma: A Retrospective Cohort Study Including Patients with More than 10 Years of Follow-up (Jeong et al. 2025)9

  • Retrospective evaluation of 71 low-risk papillary thyroid microcarcinoma (PTMC) nodules (2.3-9.5 mm diameter) treated using RFA in 65 patients
  • Number of RFA treatments:
    • 80% one treatment
    • 20% two treatments
  • Average nodule volume reduction:
    • 40.8% after 6 months
    • 74.6% after 1 year
    • 100% after 2-10 years
  • Nodular regrowth rate: 0%
  • Delayed surgery rate: 7.7%
    • Due to newly developed papillary thyroid carcinomas (PTC), not regrowth of treated nodules
    • Average time from RFA to surgery: 6.3 years
  • Complications rate: 4.6% minor, 1.5% major (subclinical hypothyroidism)
  • Conclusions:
    • RFA of low-risk PTMC is effective and safe.
    • No local tumor progression or metastases were observed.
    • 7.7% of patients developed a new PTC.

From Evidence to Application: Clinical Relevance of Current Research

The sustained clinical efficacy of radiofrequency ablation (RFA) underscores its reliability as a therapeutic modality and is actively influencing contemporary clinical approaches to the management of benign thyroid nodules. Long-term clinical evidence, like that of the above studies, adds to thyroid RFA’s already robust track record of safety and efficacy, and supports further refinement of treatment algorithms.4,7-9 This evidence also further underscores how RFA surpasses other thyroid ablation modalities, such as microwave ablation (MWA) and laser ablation (LA), in terms of published clinical data,10-12 nodule size reduction,12-23 rate of complications,11,13,17,19,24-26 simplicity and learning curve.23,27 For interventional radiologists, otolaryngologists, endocrine surgeons, and endocrinologists, RFA is increasingly recognized as a first-line treatment for appropriately selected patients.11,28 As of January 2025, it is the only thyroid ablation technique that has a specific category I CPT in the United States (CPT 60660 and 60661).29

Thyroid RFA System from Cambridge Interventional

Cambridge Interventional’s CRF radiofrequency ablation system offers a user-friendly interface that makes the system accessible and efficient. The system’s unique audio-visual feedback increases information and physician confidence, adding to the benefits of RFA’s favorable learning curve.5,23 As RFA reshapes how providers approach thyroid nodules with advantages like minimal invasiveness, fewer complications, and preservation of thyroid function,4,5 the RFA system from Cambridge Interventional is becoming the preferred choice for many physicians new to the procedure.

Contact Cambridge Interventional for expert guidance on how thyroid RFA can serve as a non-surgical thyroid care option and improve patient outcomes. Schedule a discovery call.

References

  1. Dupuy DE, Monchik JM, Decrea C, Pisharodi L. Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. Surgery. 2001 Dec;130(6):971-7. doi: 10.1067/msy.2001.118708. Erratum in: Surgery. 2022 Apr;171(4):1138. doi: 10.1016/j.surg.2021.12.008.
  2. Kim YS, Rhim H, Tae K, Park DW, Kim ST. Radiofrequency ablation of benign cold thyroid nodules: initial clinical experience. Thyroid. 2006 Apr;16(4):361-7. doi: 10.1089/thy.2006.16.361
  3. Baek JH, Jeong HJ, Kim YS, Kwak MS, Lee D. Radiofrequency ablation for an autonomously functioning thyroid nodule. Thyroid. 2008 Jun;18(6):675-6. doi: 10.1089/thy.2007.0274
  4. Tufano RP, Pace-Asciak P, Russell JO, Suárez C, Randolph GW, López F, Shaha AR, Mäkitie A, Rodrigo JP, Kowalski LP, Zafereo M, Angelos P, Ferlito A. Update of Radiofrequency Ablation for Treating Benign and Malignant Thyroid Nodules. The Future Is Now. Front Endocrinol (Lausanne). 2021 Jun 24;12:698689. doi: 10.3389/fendo.2021.698689
  5. Sinclair CF, Baek JH, Hands KE, Hodak SP, Huber TC, Hussain I, Lang BH, Noel JE, Papaleontiou M, Patel KN, Russ G, Russell J, Spiezia S, Kuo JH. General Principles for the Safe Performance, Training, and Adoption of Ablation Techniques for Benign Thyroid Nodules: An American Thyroid Association Statement. Thyroid. 2023 Oct;33(10):1150-1170. doi: 10.1089/thy.2023.0281.
  6. Mauri G, Hegedüs L, Bandula S, Cazzato RL, Czarniecka A, Dudeck O, Fugazzola L, Netea-Maier R, Russ G, Wallin G, Papini E. European Thyroid Association and Cardiovascular and Interventional Radiological Society of Europe 2021 Clinical Practice Guideline for the Use of Minimally Invasive Treatments in Malignant Thyroid Lesions. Eur Thyroid J. 2021 Jun;10(3):185-197. doi: 10.1159/000516469.
  7. Park SI, Baek JH, Lee DH, Chung SR, Song DE, Kim WG, Kim TY, Sung TY, Chung KW, Lee JH. Radiofrequency Ablation for the Treatment of Benign Thyroid Nodules: 10-Year Experience. Thyroid. 2024 Aug;34(8):990-998. doi: 10.1089/thy.2024.0082.
  8. Shin JH, Seo M, Lee MK, Jung SL. Radiofrequency Ablation of Benign Thyroid Nodules: 10-Year Follow-Up Results From a Single Center. Korean J Radiol. 2025 Feb;26(2):193-203. doi: 10.3348/kjr.2024.0599.
  9. Jeong SY, Baek SM, Shin S, Son JM, Kim H, Baek JH. Radiofrequency Ablation of Low-Risk Papillary Thyroid Microcarcinoma: A Retrospective Cohort Study Including Patients with More than 10 Years of Follow-up. Thyroid. 2025 Feb;35(2):143-152. doi: 10.1089/thy.2024.0535.
  10. Orloff LA, Noel JE, Stack BC Jr, Russell MD, Angelos P, Baek JH, Brumund KT, Chiang FY, Cunnane MB, Davies L, Frasoldati A, Feng AY, Hegedüs L, Iwata AJ, Kandil E, Kuo J, Lombardi C, Lupo M, Maia AL, McIver B, Na DG, Novizio R, Papini E, Patel KN, Rangel L, Russell JO, Shin J, Shindo M, Shonka DC Jr, Karcioglu AS, Sinclair C, Singer M, Spiezia S, Steck JH, Steward D, Tae K, Tolley N, Valcavi R, Tufano RP, Tuttle RM, Volpi E, Wu CW, Abdelhamid Ahmed AH, Randolph GW. Radiofrequency ablation and related ultrasound-guided ablation technologies for treatment of benign and malignant thyroid disease: An international multidisciplinary consensus statement of the American Head and Neck Society Endocrine Surgery Section with the Asia Pacific Society of Thyroid Surgery, Associazione Medici Endocrinologi, British Association of Endocrine and Thyroid Surgeons, European Thyroid Association, Italian Society of Endocrine Surgery Units, Korean Society of Thyroid Radiology, Latin American Thyroid Society, and Thyroid Nodules Therapies Association. Head Neck. 2022 Mar;44(3):633-660. doi: 10.1002/hed.26960.
  11. Papini E, Monpeyssen H, Frasoldati A, Hegedüs L. 2020 European Thyroid Association Clinical Practice Guideline for the Use of Image-Guided Ablation in Benign Thyroid Nodules. Eur Thyroid J. 2020 Jul;9(4):172-185. doi: 10.1159/000508484.
  12. Dobnig H, Zechmann W, Hermann M, Lehner M, Heute D, Mirzaei S, Gessl A, Stepan V, Höfle G, Riss P, Simon A. Radiofrequency ablation of thyroid nodules: “Good Clinical Practice Recommendations” for Austria : An interdisciplinary statement from the following professional associations: Austrian Thyroid Association (ÖSDG), Austrian Society for Nuclear Medicine and Molecular Imaging (OGNMB), Austrian Society for Endocrinology and Metabolism (ÖGES), Surgical Endocrinology Working Group (ACE) of the Austrian Surgical Society (OEGCH). Wien Med Wochenschr. 2020 Feb;170(1-2):6-14. doi: 10.1007/s10354-019-0682-2. Epub 2019 Feb 6. PMID: 30725443.
  13. Choi Y, Jung SL. Efficacy and Safety of Thermal Ablation Techniques for the Treatment of Primary Papillary Thyroid Microcarcinoma: A Systematic Review and Meta-Analysis. Thyroid. 2020 May;30(5):720-731. doi: 10.1089/thy.2019.0707.
  14. Trimboli P, Castellana M, Sconfienza LM, Virili C, Pescatori LC, Cesareo R, Giorgino F, Negro R, Giovanella L, Mauri G. Efficacy of thermal ablation in benign non-functioning solid thyroid nodule: A systematic review and meta-analysis. Endocrine. 2020 Jan;67(1):35-43. doi: 10.1007/s12020-019-02019-3.
  15. Bernardi S, Giudici F, Cesareo R, Antonelli G, Cavallaro M, Deandrea M, Giusti M, Mormile A, Negro R, Palermo A, Papini E, Pasqualini V, Raggiunti B, Rossi D, Sconfienza LM, Solbiati L, Spiezia S, Tina D, Vera L, Stacul F, Mauri G. Five-Year Results of Radiofrequency and Laser Ablation of Benign Thyroid Nodules: A Multicenter Study from the Italian Minimally Invasive Treatments of the Thyroid Group. Thyroid. 2020 Dec;30(12):1759-1770. doi: 10.1089/thy.2020.0202.
  16. Ha EJ, Baek JH, Kim KW, Pyo J, Lee JH, Baek SH, Døssing H, Hegedüs L. Comparative efficacy of radiofrequency and laser ablation for the treatment of benign thyroid nodules: systematic review including traditional pooling and bayesian network meta-analysis. J Clin Endocrinol Metab. 2015 May;100(5):1903-11. doi: 10.1210/jc.2014-4077.
  17. Cesareo R, Pacella CM, Pasqualini V, Campagna G, Iozzino M, Gallo A, Lauria Pantano A, Cianni R, Pedone C, Pozzilli P, Taffon C, Crescenzi A, Manfrini S, Palermo A. Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomized, Parallel, Open-Label, Trial (LARA Trial). Thyroid. 2020 Jun;30(6):847-856. doi: 10.1089/thy.2019.0660.
  18. Cesareo R, Manfrini S, Pasqualini V, Ambrogi C, Sanson G, Gallo A, Pozzilli P, Pedone C, Crescenzi A, Palermo A. Laser Ablation Versus Radiofrequency Ablation for Thyroid Nodules: 12-Month Results of a Randomized Trial (LARA II Study). J Clin Endocrinol Metab. 2021 May 13;106(6):1692-1701. doi: 10.1210/clinem/dgab102.
  19. Cho SJ, Baek JH, Chung SR, Choi YJ, Lee JH. Long-Term Results of Thermal Ablation of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis. Endocrinol Metab (Seoul). 2020 Jun;35(2):339-350. doi: 10.3803/EnM.2020.35.2.339.
  20. Tong M, Li S, Li Y, Li Y, Feng Y, Che Y. Efficacy and safety of radiofrequency, microwave and laser ablation for treating papillary thyroid microcarcinoma: a systematic review and meta-analysis. Int J Hyperthermia. 2019;36(1):1278-1286. doi: 10.1080/02656736.2019.1700559.
  21. Guo DM, Chen Z, Zhai YX, Su HH. Comparison of radiofrequency ablation and microwave ablation for benign thyroid nodules: A systematic review and meta-analysis. Clin Endocrinol (Oxf). 2021 Jul;95(1):187-196. doi: 10.1111/cen.14438.
  22. Zufry H, Hariyanto TI. Comparative Efficacy and Safety of Radiofrequency Ablation and Microwave Ablation in the Treatment of Benign Thyroid Nodules: A Systematic Review and Meta-Analysis. Korean J Radiol. 2024 Mar;25(3):301-313. doi: 10.3348/kjr.2023.1004.
  23. Lim H, Cho SJ, Baek JH. Comparative efficacy and safety of radiofrequency ablation and microwave ablation in benign thyroid nodule treatment: a systematic review and meta-analysis. Eur Radiol. 2025 Feb;35(2):612-623. doi: 10.1007/s00330-024-10881-7.
  24. Cheng Z, Che Y, Yu S, Wang S, Teng D, Xu H, Li J, Sun D, Han Z, Liang P. US-Guided Percutaneous Radiofrequency versus Microwave Ablation for Benign Thyroid Nodules: A Prospective Multicenter Study. Sci Rep. 2017 Aug 25;7(1):9554. doi: 10.1038/s41598-017-09930-7.
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  28. Kim JH, Baek JH, Lim HK, Ahn HS, Baek SM, Choi YJ, Choi YJ, Chung SR, Ha EJ, Hahn SY, Jung SL, Kim DS, Kim SJ, Kim YK, Lee CY, Lee JH, Lee KH, Lee YH, Park JS, Park H, Shin JH, Suh CH, Sung JY, Sim JS, Youn I, Choi M, Na DG; Guideline Committee for the Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology. 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology. Korean J Radiol. 2018 Jul-Aug;19(4):632-655. doi: 10.3348/kjr.2018.19.4.632.
  29. Department of Health and Human Services. “Medicare and Medicaid Programs; CY 2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments.” Federal Register vol. 89, no. 236, pg. 97826. December 9, 2024.

Disclaimer

Indications for use: The CRF radiofrequency ablation system of Cambridge Interventional LLC (“Cambridge”) is intended for use in percutaneous, laparoscopic and intraoperative coagulation and ablation of tissue.

Disclaimer: Read the instructions for use (“IFU”) of all medical devices prior to use. Clinical results, costs, and financial/insurance coverage may vary and are not guaranteed. The information contained in the multimedia content that is contained herein or that is posted on the Cambridge Interventional website or that references or links to this text (“Content”) is for general informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment; standards of medical care or training; or the instructions, indications, and contraindications for use of Cambridge Interventional devices or any other medical devices. All information is provided in good faith, however Cambridge makes no representation or warranty of any kind, express or implied regarding the accuracy, applicability, fitness, or completeness of this information; of opinions expressed; of third-party publications referenced or summarized; or of third-party services presented. Always seek the advice of your physician about a medical condition. Never disregard professional medical advice, or delay in seeking it, because of something you have read or seen in this Content.

Adverse events: Reported adverse events or complications for RF ablation or coagulation procedures include, but are not limited to, the following (the long-term risks of RF ablations have not been established): abscess, ARDS (acute respiratory distress syndrome), arrhythmia, ascites, atrial fibrillation, bile duct injury, bile leakage, biliary fistula, biloma, bleeding, bone degeneration, bone fracture, bronchial occlusion, bronchopleural fistula, burn, cardiac arrhythmia, cardiac ischemia, chest tube, coughing, death, delayed hemorrhage into ablated tissue, device failure, device fracture in patient, diaphragm injury, diarrhea, edema, electric shock, emphysema, fever, fistula, hematoma, hematuria, hemoglobinuria, hemoptysis, hemorrhage, hemothorax, hoarseness, hypertension, hyperthyroidism, hypoesthesia, hypotension, hypothyroidism, infection, kidney atrophy, liver failure, liver insufficiency, multiple sclerosis exacerbation, muscle burn, muscle contracture, nausea/vomiting, nerve injury, neuropathy, nodule rupture, organ damage, pain, paresthesia, perforated colon, perforation, peritonitis, pes equinus injury, pleural effusion, pneumonia, pneumothorax, renal failure, skin burn, tumor recurrence, tumor seeding, urinary fistula, urinary incontinence, urinary retention, urine leakage, vasovagal reaction, vessel injury, vocal cord palsy, voice change, wound discharge. RF ablation procedures are not recommended for pregnant patients. Potential risks to the patient and/or fetus have not been established. General clinical residual risks for surgical procedures include anesthesia reaction, bleeding, blood clots, death, infection, organ injury, pain, and necessity for more invasive surgery, including open surgery, if complications occur.