Thyroid Radiofrequency Ablation Versus Thyroidectomy: Pros and Cons for Patients With Benign Thyroid Nodules

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RFA vs. Thyroidectomy: A Pro et Contra Comparison

Thyroid nodules are common, with approximately half of people developing them by age 50-60. While most are benign and require no intervention, about 5% are malignant, necessitating treatment based on the type and stage of cancer as well as the patient’s overall health.1,4 Treatment for benign thyroid nodules varies, ranging from monitoring to medication or procedural intervention, depending on the nodule’s size, symptoms, or cosmetic impact. Two primary options for intervention – Thyroid Radiofrequency Ablation (RFA) and Thyroidectomy – should be carefully evaluated, as each offers unique benefits and considerations.

Thyroidectomy Surgery

A thyroidectomy involves partial or complete removal of the thyroid gland. It is typically performed to treat thyroid cancer, thyroid nodules, and hyperthyroidism. This procedure is frequently recommended when the nodule:2

  • Exhibits suspicious features suggesting malignancy
  • Has biopsy results indicating potential cancer
  • Exceeds 4 cm in size

Thyroidectomy risks include, but are not limited to:5,6

  • General anesthesia side effects and surgical risks
  • Recovery time of two to three weeks
  • Neck scar
  • Potential lifelong need for hormone replacement therapy due to thyroid removal

Radiofrequency Ablation (RFA)

Radiofrequency ablation (RFA) is a minimally invasive treatment that uses heat generated by electrical current to shrink abnormal tissue.3 RFA has been used widely for thyroid treatment in Europe and Asia since the 2000s and 2010s. In more recent years, it has been adopted in the USA as a minimally-invasive alternative to thyroid surgery.

RFA heats thyroid nodules using a thin needle electrode, precisely targeted with ultrasound imaging. RFA offers several potential benefits for treating benign nodules, including:6

  • Shorter Recovery time: Patients often return to normal activities the day after the procedure.4
  • Convenience: Can be performed as an outpatient therapy in a clinical office setting.
  • Preservation of Thyroid Function: Targets abnormal tissue precisely, leaving the thyroid largely unaffected.
  • No General Anesthesia: Only local anesthetic may be required to numb the targeted area.

RFA vs. Thyroidectomy: Comparison at a Glance

A thyroidectomy treats malignant or large nodules by surgically removing all or part of the thyroid gland, including some healthy tissue that produces important hormones. Surgery may be required for treatment of thyroid cancer and in other challenging cases.4 However, in some cases, RFA can be used to target nodules precisely, preserving healthy thyroid tissue and regular production of thyroid hormones.6

Therefore, it’s important to carefully assess both options when considering how to best treat patients with benign thyroid nodules. The following table compares some typical features of RFA and thyroidectomy.6

Radiofrequency Ablation (RFA) Thyroidectomy
Preserves healthy thyroid tissue Completely removes abnormal thyroid tissue
Mitigates need for hormone replacement therapy Potential need for lifelong hormone replacement therapy
Minimally invasive procedure Invasive surgical procedure
Requires numbing the targeted area with local anesthetic Requires general anesthesia
Can be performed in less than an hour7 Performed in 1-2 hours8
Most patients return to normal activities the following day4,6 2-3 week recovery period5
Risk of small, minimal scars at the needle insertion site. In most cases, scarring is negligible. Risk of visible scarring on the front of the neck
Lower procedure cost and outpatient treatment, paving the way for greater accessibility9 Higher cost procedure9

Why Choose Cambridge Interventional?

Cambridge Interventional’s CRF Radiofrequency Ablation System offers advanced technology designed to deliver clinical efficacy and optimize patient outcomes. Our user-friendly interface minimizes the need for complex training, making the system accessible and efficient.
RFA therapy is reshaping how providers approach benign thyroid nodule management. With benefits like minimal invasiveness, shorter recovery times, and preservation of thyroid function, RFA is becoming the preferred choice for many physicians and patients.
Contact us for a demo to learn more about how our intuitive CRF Radiofrequency Ablation System can help you provide the best care for your patients.


Sources:

  1. Thyroid Nodules: What to Do if You Find a Lump. Phelpshealth.org. Published 2022. Accessed December 12, 2024. https://phelpshealth.org/news/latest-news/thyroid-nodules-what-do-if-you-find-lump
  2. Kamran SC, Marqusee E, Kim MI, et al. Thyroid Nodule Size and Prediction of Cancer. The Journal of Clinical Endocrinology & Metabolism. 2013;98(2):564-570. doi: https://doi.org/10.1210/jc.2012-2968
  3. Shin JH, Baek JH, Ha EJ, Lee JH. Radiofrequency Ablation of Thyroid Nodules: Basic Principles and Clinical Application. International Journal of Endocrinology. 2012;2012:919650. doi: https://doi.org/10.1155/2012/919650
  4. Thyroid Nodules: When to Worry. www.hopkinsmedicine.org. Published August 8, 2021. https://www.hopkinsmedicine.org/health/conditions-and-diseases/thyroid-nodules-when-to-worry
  5. Thyroidectomy. Cleveland Clinic. Published September 8, 2022. https://my.clevelandclinic.org/health/treatments/7016-thyroidectomy
  6. Thyroid Radiofrequency Ablation (RFA) | Rutgers Cancer Institute of New Jersey. Cinj.org. Published 2023. Accessed December 12, 2024. https://www.cinj.org/patient-care/thyroid-radiofrequency-ablation-rfa
  7. 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: https://doi.org/10.1159/000508484
  8. Thyroidectomy. Mayo Clinic. Published September 3, 2022. https://www.mayoclinic.org/tests-procedures/thyroidectomy/about/pac-20385195
  9. Miller JR, Tanavde V, Razavi C, Saraswathula A, Russell JO, Tufano RP. Cost comparison between open thyroid lobectomy and radiofrequency ablation for management of thyroid nodules. Head Neck. 2023 Jan;45(1):59-63. doi: https://doi.org/10.1002/hed.27213

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 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.

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