Comparison of radiofrequency ablation and microwave ablation for benign thyroid nodules: A systematic review and meta‐analysis

Purpose To compare the effectiveness and safety of radiofrequency ablation (RFA) and microwave ablation (MWA) for the treatment of benign thyroid nodules (BTNs). Methods PubMed, Embase and Cochrane databases were searched up to September 11, 2020. Volume reduction rate (VRR), symptomatic and cosmetic scores analysed by standardized mean difference (SMD), and complications analysed by risk difference (RD) were performed to evaluate the efficacy and safety of RFA and MWA for treating BTNs. Results Five eligible studies were included. 899 patients with 956 BTNs and 869 patients with 938 BTNs received RFA and MWA, respectively. RFA and MWA have the similar pooled 3‐month (56.0% vs. 53.9%, p = .668) and 6‐month (80.8% vs. 74.9%, p = .080) VRRs. But RFA showed a significantly higher VRR than MWA after 12 months (86.2% vs. 80.0%, p = .036). The pooled symptomatic and cosmetic scores decreased significantly after 6 and 12 months in both RFA and MWA. The improvements of symptoms were equivalent between two groups at 6 (SMD: 1.17 vs. 1.12, p = .930) and 12 (SMD: 1.46 vs. 1.45, p = .930) months. No significant differences in cosmetic scores were found between two groups at 6 (SMD: 0.87 vs. 0.94, p = 0. 334) and 12 (SMD: 1.21 vs. 1.15, p = 0. 872) months. Major (RD = −0.02, P = .107) and minor (RD = 0.00, p = .661) complications did not significantly differ between RFA and MWA. Conclusions RFA and MWA are effective and safe treatment modalities for BTNs. But RFA showed a superior 12‐month VRR. RFA may have a better long‐term effect on volume reduction of nodules compared with MWA.