Levothyroxine or minimally invasive therapies for benign thyroid nodules

Abstract

No study evaluated all-cause mortality, health-related quality of life or provided systematic data on the development of thyroid cancer. Longest follow-up was five years and median follow-up was 12 months. Nodule volume reductions were achieved by PEI, LP and RF, and to a lesser extent, by LT4. However, the clinical relevance of this outcome measure is doubtful. PEI, LP and RF led to improvements in pressure symptoms and cosmetic complaints. Adverse events such as light-to-moderate periprocedural pain were seen after PEI, LP and RF. Future studies should focus on patient-important outcome measures, especially health-related quality of life, and compare minimally invasive procedures with surgery. RCTs with follow-up periods of several years and good-quality observational studies are needed to provide evidence on the development of thyroid cancer, all-cause mortality and long-term adverse events.

Efficacy and Safety of Thermal Ablation for Indeterminate Thyroid Nodules: A Systematic Review of the Literature and Meta-Analysis

“…After removing 42 duplicates, 193 articles remained for screening on the basis of their titles and abstracts, resulting in 29 potentially eligible articles. Upon reviewing the full text of the 29 provisionally eligible articles (Supplementary Table S1), it was found that one was a case report, 37 six were conference abstracts, 38 –43 three were review articles, 44 –46 one potentially involved overlapping data, 47 and three were not relevant to the field of interest. 48 –50 Ultimately, 15 articles were included in this study.…”

Efficacy and Safety of Thermal Ablation for Indeterminate Thyroid Nodules: A Systematic Review of the Literature and Meta-Analysis

“…After removing 42 duplicates, 193 articles remained for screening on the basis of their titles and abstracts, resulting in 29 potentially eligible articles. Upon reviewing the full text of the 29 provisionally eligible articles (Supplementary Table S1), it was found that one was a case report, 37 six were conference abstracts, 38 –43 three were review articles, 44 –46 one potentially involved overlapping data, 47 and three were not relevant to the field of interest. 48 –50 Ultimately, 15 articles were included in this study.…”

High intensity focused ultrasound (HIFU) ablation of benign thyroid nodules – a systematic review

“…Eleven articles were identified from our electronic search and of these, 2 were review articles [ 7 , 16 ], 1 was a case report [ 17 ], 1 was an animal study [ 14 ] and 1 was an editorial [ 18 ]. Therefore, 6 articles were deemed to be original articles.…”

“…Therefore, in the end, only 5 studies [ 15 , 19 , 21 – 24 ] were considered to contain original data. No additional study was found from our search of the bibliographies of the two review articles [ 7 , 16 ]. In terms of country of origin, the first published article came from France [ 15 ].…”

Percutaneous laser ablation for benign thyroid nodules: a meta-analysis

“…Due to a lack of sufficient data, we were unable to perform further analysis to elucidate the relationship between complications and PLA treatment. However, previous research has not found any significant relationship between complications and PLA or RFA in treating TNs [ 4 , 6 , 7 , 15 ]. Off-target effects have, however, been reported in previous research on the treatment of liver disease with RFA [ 53 , 54 ].…”

Efficacy and Safety of Thermal Ablation for Indeterminate Thyroid Nodules: A Systematic Review of the Literature and Meta-Analysis

“…After removing 42 duplicates, 193 articles remained for screening on the basis of their titles and abstracts, resulting in 29 potentially eligible articles. Upon reviewing the full text of the 29 provisionally eligible articles (Supplementary Table S1), it was found that one was a case report, 37 six were conference abstracts, 38 –43 three were review articles, 44 –46 one potentially involved overlapping data, 47 and three were not relevant to the field of interest. 48 –50 Ultimately, 15 articles were included in this study.…”

High intensity focused ultrasound (HIFU) ablation of benign thyroid nodules – a systematic review

“…Eleven articles were identified from our electronic search and of these, 2 were review articles [ 7 , 16 ], 1 was a case report [ 17 ], 1 was an animal study [ 14 ] and 1 was an editorial [ 18 ]. Therefore, 6 articles were deemed to be original articles.…”

“…Therefore, in the end, only 5 studies [ 15 , 19 , 21 – 24 ] were considered to contain original data. No additional study was found from our search of the bibliographies of the two review articles [ 7 , 16 ]. In terms of country of origin, the first published article came from France [ 15 ].…”

Percutaneous laser ablation for benign thyroid nodules: a meta-analysis

“…Due to a lack of sufficient data, we were unable to perform further analysis to elucidate the relationship between complications and PLA treatment. However, previous research has not found any significant relationship between complications and PLA or RFA in treating TNs [ 4 , 6 , 7 , 15 ]. Off-target effects have, however, been reported in previous research on the treatment of liver disease with RFA [ 53 , 54 ].…”

Efficacy and Safety of Thermal Ablation for Indeterminate Thyroid Nodules: A Systematic Review of the Literature and Meta-Analysis

“…After removing 42 duplicates, 193 articles remained for screening on the basis of their titles and abstracts, resulting in 29 potentially eligible articles. Upon reviewing the full text of the 29 provisionally eligible articles (Supplementary Table S1), it was found that one was a case report, 37 six were conference abstracts, 38 –43 three were review articles, 44 –46 one potentially involved overlapping data, 47 and three were not relevant to the field of interest. 48 –50 Ultimately, 15 articles were included in this study.…”

High intensity focused ultrasound (HIFU) ablation of benign thyroid nodules – a systematic review

“…Eleven articles were identified from our electronic search and of these, 2 were review articles [ 7 , 16 ], 1 was a case report [ 17 ], 1 was an animal study [ 14 ] and 1 was an editorial [ 18 ]. Therefore, 6 articles were deemed to be original articles.…”

“…Therefore, in the end, only 5 studies [ 15 , 19 , 21 – 24 ] were considered to contain original data. No additional study was found from our search of the bibliographies of the two review articles [ 7 , 16 ]. In terms of country of origin, the first published article came from France [ 15 ].…”

Percutaneous laser ablation for benign thyroid nodules: a meta-analysis

“…Due to a lack of sufficient data, we were unable to perform further analysis to elucidate the relationship between complications and PLA treatment. However, previous research has not found any significant relationship between complications and PLA or RFA in treating TNs [ 4 , 6 , 7 , 15 ]. Off-target effects have, however, been reported in previous research on the treatment of liver disease with RFA [ 53 , 54 ].…”