Endocrine Abstracts

Objectives: Radiofrequency ablation (RFA) is considered an alternative treatment for benign thyroid nodules and malignant thyroid cancers. There were various clinical practice guidelines from international societies for ablation of benign thyroid nodules. Recently, RFA is becoming a promising treatment choice for recurrence thyroid cancer, and RFA is suggested as a minimally invasive treatment for low-risk papillary thyroid microcarcinoma (PTMC). Several international societies also proposed clinical practice guidelines for malignant thyroid cancers. Therefore, we systemically reviewed these clinical practice guidelines for benign and malignant thyroid RFA and compared the similarities and differences between them to identify a standard treatment strategy.

Methods: The Ovid-MEDLINE and Embase were searched and a manual search was conducted to identify articles for RFA of benign thyroid nodules and malignant thyroid cancers. Studies that included clinical practice guideline of benign and malignant thyroid RFA were included. We extracted data on the indication, pre- and post-procedural evaluation, techniques, efficacy, safety, preference and cost, and informed consent.

Results: Sixteen guidelines were included. These studies were guidelines developed by 10 international thyroid societies including the Korean Society of Thyroid Radiology (KSThR), three French thyroid associations, Italian scientific societies and Italian minimally invasive treatment of the thyroid, international multidisciplinary thyroid association, European Thyroid association (ETA), committee of Asian Conference on Tumor Ablation, American Association of Clinical Endocrinology (AACE), Thyroid Tumor Ablation Experts Groups of Chinese Medical Doctor Association, three German thyroid associations, and four professional Austrian thyroid associations. All guidelines suggested the clinical practice guidelines for ablation of benign thyroid nodules, and most societies except French thyroid associations and German thyroid associations suggested the malignant thyroid cancer RFA. Most guidelines were included indications, pre- and post-procedural evaluation, techniques, efficacy, and safety for thyroid RFA. Two societies, AACE and ETA, described the cost of benign and malignant thyroid RFA, and ETA only suggested the preference according to the patients’ status.

Conclusion: Most guidelines were included the similar major contents for benign and malignant thyroid RFA. Systematic review of various guidelines for benign and malignant thyroid RFA can be help to establish the standard treatment strategy.