Exploring the Long-Term Clinical Efficacy of Radiofrequency Ablation of Thyroid Nodules

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Thyroid nodules are a prevalent clinical finding, affecting up to 68% of the general population. While most are benign, symptoms can still be troublesome and may present aesthetic concerns.1 Historically, surgical removal (thyroidectomy) has been the primary intervention for managing these nodules. However, minimally invasive therapies like Radiofrequency Ablation (RFA) are now reshaping thyroid treatment, offering patients a safe, effective, non-surgical alternative to thyroidectomy with improved safety and health-related quality of life.2-5

Thyroid RFA: Treatment Overview

Thyroid RFA is a minimally invasive procedure that utilizes heat generated by an electrified needle to precisely target and shrink benign thyroid nodules. Treated nodules shrink immediately and continue to shrink over the next 6-12 months, with typical size reduction of 50-90%. Performed under ultrasound guidance and without general anesthesia, RFA effectively alleviates local symptoms with less invasiveness than surgery and, most importantly, typically without causing hypothyroidism.2,6

Long-Term Efficacy: Research-Backed Benefits to RFA

One of the most compelling aspects of RFA is its proven long-term efficacy in reducing the size of benign thyroid nodules. Over the past two decades, studies with long-term follow-up periods have demonstrated significant and sustained reductions in mean thyroid nodule volume.

Key Findings from Long-Term Studies

Retrospective Study (Lim 2013)

  • 93.4% volume reduction four years after RFA treatment, with only 2 major complications in 111 patients.7

Prospective Multicenter Study (Jung 2018)

  • 95.3% reduction in nodule volume at the five-year mark, with only 3 major complications in 276 patients.8

Longitudinal Observational Study (Deandrea 2019)

  • 67% sustained reduction in nodule size over the five years following a single session of RFA, with no major complications in 215 patients.9

Retrospective Multicenter Study (Bernardi 2020)

  • 77% median reduction in nodule size over five years for 216 RFA patients. RFA patients were also shown to have a lower rate of regrowth and need for retreatment than 190 laser-ablation patients, whose median nodules size reduction was only 57% after five years.10

Clinical Implications: Translating Research into Practice

The long-term clinical efficacy of RFA not only reinforces its value as a reliable treatment, but is also actively shaping how clinicians manage benign thyroid nodules today.2 For endocrinologists, endocrine surgeons, ENT specialists, and interventional radiologists, RFA is increasingly considered a first-line option for appropriate candidates.11 It offers an evidence-backed, minimally invasive alternative that delivers consistent results with fewer complications.2

Patient Selection for Thyroid RFA Therapy

While RFA is highly effective, patient selection is key to optimizing outcomes. Research shows the procedure can be considered for:

  • Patients with a benign thyroid nodule producing compressive or cosmetic complaints, such as difficulty swallowing, speaking, or breathing.
  • Individuals who are poor candidates for surgery or prefer to avoid it.
  • Patients who do not want to risk hypothyroidism, visible scarring, hoarseness, or longer surgical recovery time.1,2,12

The Bottom Line: A Paradigm Shift in Thyroid Nodule Treatment

With robust long-term data, high success rates, and a favorable safety profile, RFA is transforming how benign thyroid nodules are treated. Its ability to significantly reduce nodule volume, preserve thyroid function, and minimize complications makes it an evidence-based alternative to surgery. As more clinicians adopt this technology, patients stand to benefit from an effective, non-surgical approach to care.2,11

Ready to Integrate RFA Into Your Practice?

As the only U.S.-based manufacturer of thyroid RFA equipment, Cambridge Interventional offers the CRF Thyroid RFA System, an advanced ablation solution delivering powerful benefits for both clinicians and patients. Schedule a discovery call today to explore how it can elevate your approach to benign thyroid nodule treatment.

References

  1. Durante C, Grani G, Lamartina L, Filetti S, Mandel SJ, Cooper DS. The Diagnosis and Management of Thyroid Nodules: A Review. JAMA. 2018 Mar 6;319(9):914-924. doi: 10.1001/jama.2018.0898.
  2. 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.
  3. Bernardi S, Dobrinja C, Fabris B, Bazzocchi G, Sabato N, Ulcigrai V, Giacca M, Barro E, De Manzini N, Stacul F. Radiofrequency ablation compared to surgery for the treatment of benign thyroid nodules. Int J Endocrinol. 2014;2014:934595. doi: 10.1155/2014/934595.
  4. Che Y, Jin S, Shi C, Wang L, Zhang X, Li Y, Baek JH. Treatment of Benign Thyroid Nodules: Comparison of Surgery with Radiofrequency Ablation. AJNR Am J Neuroradiol. 2015 Jul;36(7):1321-5. doi: 10.3174/ajnr.A4276.
  5. Jin H, Lin W, Lu L, Cui M. Conventional thyroidectomy vs thyroid thermal ablation on postoperative quality of life and satisfaction for patients with benign thyroid nodules. Eur J Endocrinol. 2021 Jan;184(1):131-141. doi: 10.1530/EJE-20-0562.
  6. 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;9(4):172-185. doi: https://doi.org/10.1159/000508484
  7. Lim HK, Lee JH, Ha EJ, Sung JY, Kim JK, Baek JH. Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients. Eur Radiol. 2013 Apr;23(4):1044-9. doi: 10.1007/s00330-012-2671-3.
  8. Jung SL, Baek JH, Lee JH, et al. Efficacy and Safety of Radiofrequency Ablation for Benign Thyroid Nodules: A Prospective Multicenter Study. Korean Journal of Radiology. 2018;19(1):167. doi: https://doi.org/10.3348/kjr.2018.19.1.167
  9. Deandrea M, Trimboli P, Garino F, et al. Long-Term Efficacy of a Single Session of RFA for Benign Thyroid Nodules: A Longitudinal 5-Year Observational Study. The Journal of Clinical Endocrinology and Metabolism. 2019;104(9):3751-3756. doi: https://doi.org/10.1210/jc.2018-02808
  10. 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.
  11. Lui MS, Patel KN. Current guidelines for the application of radiofrequency ablation for thyroid nodules: a narrative review. Gland surgery. 2024;13(1):59-69. doi: https://doi.org/10.21037/gs-23-18
  12. Sinclair, C. F., Jung Hwan Baek, Hands, K. E., Hodak, S. P., Huber, T. C., Hussain, I., Brian Hung‐Hin Lang, Noel, J. E., Papaleontiou, M., Patel, K. N., Russ, G., Russell, J. O., Stefano Spiezia, & Kuo, J. H. (2023). General Principles for the Safe Performance, Training, and Adoption of Ablation Techniques for Benign Thyroid Nodules: An American Thyroid Association Statement. Thyroid, 33(10), 1150–1170. https://doi.org/10.1089/thy.2023.0281

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.