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Research ArticleHEAD & NECK

Ultrasound-Guided Radiofrequency Ablation versus Thyroidectomy for the Treatment of Benign Thyroid Nodules in Elderly Patients: A Propensity-Matched Cohort Study

L. Yan, X.Y. Li, Y. Li and Y. Luo
American Journal of Neuroradiology May 2023, DOI: https://doi.org/10.3174/ajnr.A7890
L. Yan
aFrom the Department of Ultrasound, The First Medical Centre, Chinese People’s Liberation Army General Hospital, Haidian District, Beijing, China
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X.Y. Li
aFrom the Department of Ultrasound, The First Medical Centre, Chinese People’s Liberation Army General Hospital, Haidian District, Beijing, China
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  • ORCID record for X.Y. Li
Y. Li
aFrom the Department of Ultrasound, The First Medical Centre, Chinese People’s Liberation Army General Hospital, Haidian District, Beijing, China
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Y. Luo
aFrom the Department of Ultrasound, The First Medical Centre, Chinese People’s Liberation Army General Hospital, Haidian District, Beijing, China
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Abstract

BACKGROUND AND PURPOSE: Ultrasound-guided radiofrequency ablation has been recommended as an alternative to surgery for benign thyroid nodules. However, little is known about the benefit from the application of radiofrequency ablation for benign thyroid nodules in elderly patients. The purpose of this study was to compare the clinical outcomes of radiofrequency ablation versus thyroidectomy for elderly patients with benign thyroid nodules.

MATERIALS AND METHODS: This retrospective study evaluated 230 elderly patients (60 years of age or older) with benign thyroid nodules treated with radiofrequency ablation (R group, n = 49) or thyroidectomy (T group, n = 181). Complications, thyroid function, and treatment variables, including procedural time, estimated blood loss, hospitalization, and cost, were compared after propensity score matching. The volume, volume reduction rate, symptoms, and cosmetic score were also evaluated in the R group.

RESULTS: After 1:1 matching, each group had 49 elderly patients. The rate of overall complications and hypothyroidism was 26.5% and 20.4% in the T group, respectively, but these complications were totally absent from the R group (P < .001, P = .001). Patients in the R group had a significantly shorter procedural time (median, 4.8 versus 95.0 minutes, P < .001) and lower cost (US $1979.02 versus US $2208.80, P = .013) than those treated by thyroidectomy. After radiofrequency ablation, the volume reduction rate was 94.1%, and 12.2% of nodules had completely disappeared. The symptom and cosmetic scores were both significantly reduced at the last follow-up.

CONCLUSIONS: Radiofrequency ablation could be considered as a first-line treatment for elderly patients with benign thyroid nodules.

ABBREVIATIONS:

IQR
interquartile range
PSM
propensity score matching
PTMC
papillary thyroid microcarcinoma
RFA
radiofrequency ablation
RLN
recurrent laryngeal nerve
US
ultrasound
VRR
volume reduction rate

Footnotes

  • Disclosure forms provided by the authors are available with the full text and PDF of this article at www.ajnr.org.

  • © 2023 by American Journal of Neuroradiology
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Ultrasound-Guided Radiofrequency Ablation versus Thyroidectomy for the Treatment of Benign Thyroid Nodules in Elderly Patients: A Propensity-Matched Cohort Study
L. Yan, X.Y. Li, Y. Li, Y. Luo
American Journal of Neuroradiology May 2023, DOI: 10.3174/ajnr.A7890

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Ultrasound-Guided Radiofrequency Ablation versus Thyroidectomy for the Treatment of Benign Thyroid Nodules in Elderly Patients: A Propensity-Matched Cohort Study
L. Yan, X.Y. Li, Y. Li, Y. Luo
American Journal of Neuroradiology May 2023, DOI: 10.3174/ajnr.A7890
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