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Letter

Is Radiofrequency Ablation an Alternative to Thyroidectomy?

S. Tez and M. Tez
American Journal of Neuroradiology September 2015, 36 (9) E60; DOI: https://doi.org/10.3174/ajnr.A4466
S. Tez
aRadiology Clinic 19 Mayıs Hospital Dikmen, Ankara, Turkey
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M. Tez
bSurgery Clinic Ankara Numune Training and Research Hospital Sıhhiye, Ankara, Turkey
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We have read the article entitled “Treatment of Benign Thyroid Nodules: Comparison of Surgery with Radiofrequency Ablation” with great interest and congratulate the authors.1

Since Dupuy et al2 published the application of radiofrequency ablation to treat recurrent thyroid cancers, radiofrequency ablation has been widely used for the treatment of benign thyroid goiters. However, there are some issues that must be clarified in the present article.

  1. What are the pathology results of the thyroidectomy group? Is there a malignant pathology report?

    Incidental papillary carcinoma (IPC) of the thyroid has been accepted widely as a tumor measuring ≤1 cm. A 10% incidence of patients with IPC with multinodular goiter with benign cytology was reported in the study of Bradly et al.3 Although IPC progression is infrequent, a few cases of local spread or nodal metastases are reported in the long-term, and most patients can be effectively treated with lobectomy or thyroidectomy.4

  2. What is the number of total thyroidectomy and lobectomy procedures? Are surgical complications different in these groups?

    Unilateral thyroidectomy (lobectomy) may be preferred to retain some function of the thyroid, allowing patients to avoid life-long hormone replacement therapy. The complication rate after total thyroidectomy has been reported to be between 5% and 33%. On the other hand, postoperative complications after lobectomy are reported between 2% and 3%.5 Complications of radiofrequency ablation, total thyroidectomy, and lobectomy could be presented separately.

  3. The authors stated, “Comparison of the two groups was done by the Wilcoxon signed rank test” in the “Statistical Methods” section.1

The Wilcoxon signed rank test is a nonparametric statistical hypothesis test used when comparing 2 related samples, matched samples, or repeated measurements on a single sample to assess whether their population mean ranks differ. Because the surgery and radiofrequency ablation groups are not related, the Wilcoxon signed rank is not a suitable method for statistics.

References

  1. 1.↵
    1. Che Y,
    2. Jin S,
    3. Shi C, et al
    . Treatment of benign thyroid nodules: comparison of surgery with radiofrequency ablation. AJNR Am J Neuroradiol 2015 Mar 26. [Epub ahead of print] doi:10.3174/ajnr.A4276 pmid:25814656
    Abstract/FREE Full Text
  2. 2.↵
    1. Dupuy DE,
    2. Monchik JM,
    3. Decrea C, et al
    . Radiofrequency ablation of regional recurrence from well-differentiated thyroid malignancy. Surgery 2001;130:971–77 doi:10.1067/msy.2001.118708 pmid:11742325
    CrossRefPubMed
  3. 3.↵
    1. Bradly DP,
    2. Reddy V,
    3. Prinz RA, et al
    . Incidental papillary carcinoma in patients treated surgically for benign thyroid diseases. Surgery 2009;146:1099–104 doi:10.1016/j.surg.2009.09.025 pmid:19958937
    CrossRefPubMed
  4. 4.↵
    1. Papini E,
    2. Guglielmi R,
    3. Gharib H, et al
    . Ultrasound-guided laser ablation of incidental papillary thyroid microcarcinoma: a potential therapeutic approach in patients at surgical risk. Thyroid 2011;21:917–20 doi:10.1089/thy.2010.0447 pmid:21595556
    CrossRefPubMed
  5. 5.↵
    1. Bauer PS,
    2. Murray S,
    3. Clark N, et al
    . Unilateral thyroidectomy for the treatment of benign multinodular goiter. J Surg Res 2013;184:514–18 doi:10.1016/j.jss.2013.04.045 pmid:23688788
    CrossRefPubMed
  • © 2015 by American Journal of Neuroradiology
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American Journal of Neuroradiology: 36 (9)
American Journal of Neuroradiology
Vol. 36, Issue 9
1 Sep 2015
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Is Radiofrequency Ablation an Alternative to Thyroidectomy?
S. Tez, M. Tez
American Journal of Neuroradiology Sep 2015, 36 (9) E60; DOI: 10.3174/ajnr.A4466

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Is Radiofrequency Ablation an Alternative to Thyroidectomy?
S. Tez, M. Tez
American Journal of Neuroradiology Sep 2015, 36 (9) E60; DOI: 10.3174/ajnr.A4466
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