Radiofrequency Ablation for Papillary Thyroid Carcinoma versus Surgery and Other Thermal Ablation Techniques: A Systematic Review and Meta-Analysis of Outcomes.

BACKGROUND

Radiofrequency ablation (RFA) has been proposed for selected patients with low-risk papillary thyroid carcinoma (PTC). This study compared the effectiveness, safety, and procedural characteristics of RFA with those of surgery and other thermal ablation techniques.

METHODS

PubMed, Embase, Cochrane, and KoreaMed were searched for studies published between January 2000 and March 2025. Two reviewers independently extracted data in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and assessed study quality using the Risk of Bias Assessment Tool for Nonrandomized Studies, version 2. Pooled analyses were performed using random-effects models. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for dichotomous outcomes, and mean differences (MDs) were calculated for continuous outcomes.

RESULTS

Fifteen studies including 3,612 patients with PTC were analyzed. Compared with surgery, RFA was associated with a similar disease progression rate (OR, 0.91; 95% CI, 0.55 to 1.51; P=0.683) and a lower complication rate (OR, 0.35; 95% CI, 0.20 to 0.63; P=0.003). RFA was also associated with less intraoperative blood loss (MD, -21.87 mL), shorter procedure time (MD, -68.14 minutes), and shorter hospital stay (MD, -5.75 days; all P<0.001). Compared with other thermal ablation techniques, RFA showed similar disease progression rates (OR, 1.05; 95% CI, 0.16 to 7.14), complication rates (OR, 0.88; 95% CI, 0.17 to 4.49), volume reduction rates (MD, 0.02%), and complete disappearance rates (MD, 0.96%), with no statistically significant differences across outcomes.

CONCLUSION

RFA may be considered as an alternative to surgery for selected patients with low-risk PTC. Randomized trials with longer follow-up are needed to confirm its oncologic durability and safety.