A Medical Journal Summary
Radiofrequency Ablation of Thyroid Nodules: Prospective Cost-Effectiveness Analysis in Comparison to Conventional Thyroidectomy
Radiofrequency ablation of thyroid nodules is a new minimally invasive procedure. RFA has been proven to be an effective and safe treatment option while being minimally invasive and aesthetically satisfactory. With the advent of advanced imaging tests such as ultrasound, tomography, positron emission scanning, etc., the challenge of finding the most effective and economical treatment option has arisen.
Over the last few decades, the commonly used treatments for thyroid nodules were surgery, clinical observation, or hormone suppression. Unfortunately, the surgical treatment caused recurrent laryngeal nerve injury with permanent scarring and hypothyroidism. Another option was hormone suppression which wasn’t effective enough. Therefore, radiofrequency ablation has emerged, which offers satisfactory results in terms of nodule volume reduction and eliminates the need for additional surgery.
However, like other medical innovations, we must consider its cost since the high cost can be a top barrier to its implementation, specifically in developing countries like Brazil. Unfortunately, there aren’t any insights available through which the cost-effectiveness of radiofrequency ablation of thyroid nodules can be evaluated.
Therefore, to compare the costs of conventional thyroidectomy and RFA, research was conducted in which patients from Arnaldo Vieira de Carvalho Cancer Institute’s Department of Head and Neck Surgery were selected. Half of the patients were allocated to undergo thyroidectomy, and the rest to undergo Thyroid RFA treatments to determine the total cost of Thyroid RFA and thyroidectomy surgery. The patients were chosen after confirmation of their thyroid nodules’ benign cytology using fine-needle aspiration biopsy. The patients were excluded who had nodules that were suspicious or indeterminate for malignancy, nodules that were asymptomatic and smaller than 3cm, or clinical conditions that contraindicated surgery.
What Costs Were Included To Perform Cost Analysis?
To perform the cost analysis, the cost of daily stays, surgery, medications, pathology, and materials adjusted were included. Moreover, doctor’s fees, cost of procedures, and cost of special materials for RFA treatment were included.
Thyroid RFA VS Conventional Thyroidectomy – Which is more cost-effective?
After the surgery and RFA treatment, RFA enables early recovery of work activity and normal lifestyle while significantly preserving the thyroid function. In addition, Thyroid RFA was proven to be efficient and effective for autonomous and non-functioning thyroid nodules not because it eliminated the clinical problems but significantly reduced the nodule volume that was observed after a 6-month follow-up after the treatment session.
Furthermore, it’s recommended to use the US-guided Thyroid RFA technique to treat benign thyroid nodules since it offers the advantage of definitive efficacy, significant nodule volume reduction reduced damage to adjacent normal tissue, and a high nodule regression rate. There isn’t a surgical incision and RFA treatment can satisfy patients’ aesthetic demands.
Surgery is still considered the standard treatment option for benign thyroid nodules in the form of total or partial thyroidectomy. Undoubtedly, surgery offers great therapeutic efficacy, enables the evaluation of the specimen pathologically or anatomically, and is widely accepted by the medical community. However, it isn’t the most cost-effective option.
Unlike thyroidectomy, RFA therapy doesn’t need general anesthesia, is an outpatient procedure, and doesn’t cause neck scarring. Therefore, Thyroid RFA can be considered a good treatment option for benign thyroid nodules and can replace surgical treatment in some cases.
You can read the full medical case study here.
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Radiofrequency Ablation of Thyroid Nodules: Perspective Cost-effectiveness Analysis in Comparison to Conventional Thyroidectomy, Arch. Endocrinol. Metab. 65 (6) • Nov-Dec 2021https://doi.org/10.20945/2359-3997000000411
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