Meta-analysis of the efficacy and safety of thermal ablation for treating large benign thyroid nodules.

ABSTRACT

OBJECTIVE: Many large benign thyroid nodules have symptoms and cosmetic problems. This study consisted of a meta-analysis to accurately assess the effect of thermal ablation on these nodules. METHODS: The PubMed, Embase, Web of Science, and Scopus databases were systematically searched for retrospective or prospective studies of thermal ablation since June 1, 2021. The weighted mean differences of the measures were analysed before and after treatment. RESULTS: A total of 10 eligible studies were included. By comparing the initial nodule volume with the nodular volume after thermal ablation, we found that the volume reduction rate was increased significantly after 1 month (SMD = 0.453, 95% CI 0.323-0.583, p < .001), 3 months (SMD = 0.655, 95% CI 0.563-0.747, p < .001), 6 months (SMD = 0.691, 95% CI 0.607-0.774, p < .001), and 12 months (SMD = 0.694, 95% CI 0.583-0.803), p < .001). The nodular volume was also found to decrease significantly, after 1 month (SMD = 2.381, 95% CI 1.278-3.485, p < .001), 3 months (SMD = 5.071, 95% CI 2.386-7.756, p < .001), 6 months (SMD = 5.363, 95% CI 2.765-7.962, p < .001), and 12 months (SMD = 8.194, 95% CI 2.113-14.274), p < .001). Symptom score (SMD = 4.419, 95% CI 2.573-6.265, p < .001)and cosmetic score (SMD = 4.245, 95% CI 2.566-5.359, p < .001) were reduced after thermal ablation. CONCLUSIONS: Thermal ablation could become an alternative to manage large benign thyroid nodules.