Original Title: Tratamiento de nódulos tiroideos benignos mediante ablación térmica láser o radiofrecuencia

Authors' objectives: Assessing the safety and clinical effectiveness of thermal laser and radiofrequency ablation in the treatment of symptomatic benign solid TN compared to standard treatment (surgery or surveillance).

Authors' results and conclusions: The bibliographic search provided 506 references, of which 67 were read in full text, and 13 articles were selected for inclusion because they met the previously stablished inclusion criteria. To assess the safety and clinical effectiveness of laser ablation (LA) treatment, five studies including 215 TN from 210 patients were selected. In terms of safety, the results show a low rate of major complications (0.95%) and a moderate rate (26%) of minor complications and side effects, among which cervical pain caused by heating stood out. The degree of tolerance expressed by the majority of patients (>90%) was good, in 76% no complications developed, and no changes in gland function were observed, with the patients retaining their euthyroid state. In terms of effectiveness, a progressive reduction in TN volume of close to 63% (p=0.003) is indicated at 12 months. Thirty percent of the TNs reduced their volume by at least half (≥50%), and 15% had unsatisfactory results. In the case of radiofrequency ablation (RF), 8 studies describing 1549 NT from 1427 patients were selected. In terms of safety, there is a low rate of complications (7.2%), mostly of a mild, transitory and reversible nature (4.6%). Major complications reached 2.6%, of which 0.3% were permanent. Adverse effects accounted for 21%, including warmth, neck discomfort or stiffness, and pain. About 93% of the patients did not develop any complications and the degree of tolerance to the treatment was good. No significant changes in thyroid function were observed. In terms of efficacy, a gradual response to treatment is indicated, reaching an average reduction in TN volume of 97% (p

Authors' methods: A review of the scientific literature was carried out without time limitation until November 2018 in repositories of clinical practice guidelines (G-I-N, National Guideline Clearinghouse, SIGN), specialized databases of evaluation reports and systematic reviews (CRD, INAHTA, the Cochrane Library), general databases (Medline, Embase and ISI WoK) and ongoing clinical trials databases (ClinicalTrial.gov). In order to complete this phase, a manual review of the bibliography cited in these articles and additional searches of meta-search engines and websites of national and international scientific organisations and/or societies were carried out. Two independent reviewers reviewed the articles resulting from the automated search and selected studies based on previously established inclusion and exclusion criteria. All of the information was extracted from evidence tables and analysed in pairs, taking into account the risk of bias of the included studies and the quality of the evidence.

Project Status: Completed

URL for project: https://runa.sergas.gal/xmlui/handle/20.500.11940/13761

Year Published: 2020

URL for published report: http://hdl.handle.net/20.500.11940/13761

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Scientific Advice Unit, avalia-t; The Galician Health Knowledge Agency (ACIS)

Contact Address: Conselleria de Sanidade, Xunta de Galicia, San Lazaro s/n 15781 Santiago de Compostela, Spain. Tel: 34 981 541831; Fax: 34 981 542854;

Contact Name: avalia-t@sergas.es

Contact Email: avalia-t@sergas.es

Copyright: Scientific and Technical Advice Unit, avalia-t