SIR Today

Thyroid nodules affect 19 to 68% of adults, according to researchers. While most are benign, they can cause compressive issues, as well as cosmetic complaints. Standard therapy currently leans toward surgical resection, which carries risks such as hypothyroidism, vocal cord paralysis or hypoparathyroidism. Alternatively, RFA is an outpatient, thyroid-preserving procedure with evidence showing it can result in 50-90% volume reduction.

“Thyroid RFA is increasingly used in the U.S., but large-scale comparative outcome data remain limited. We wanted to directly compare RFA with surgery using a national, multi-center dataset,” said Rohit Reddy, MD, who will present this abstract at SIR 2026.

Researchers out of the University of Miami and Houston Methodist Hospital sought to evaluate real-world outcomes of thyroid radiofrequency ablation versus thyroidectomy for benign and functional thyroid nodules, focusing on complications and long-term preservation of thyroid function.

The team reviewed data from 69 health care organizations for adults who received either RFA or thyroid surgery in the past 20 years. They segmented these patients into two cohorts: those treated with RFA and those who underwent thyroidectomy, with over 2,000 patients in each group.

The data indicated very favorable outcomes for RFA in terms of efficacy, safety and risk mitigation.

“RFA was associated with markedly lower risks of hypothyroidism, hypocalcemia and vocal cord paralysis,” said Dr. Reddy. “These results support RFA as a safe, thyroid-preserving alternative to surgery in appropriately selected patients.”

In addition, researchers found that RFA showed a median time of 17 years to hyperthyroidism, compared to 3 years for thyroidectomy. Meanwhile, the safety margins were also comparable, with infection rates similar between the two cohorts.

According to Dr. Reddy, next steps include prospective and randomized studies, longer-term durability analyses and cost-effectiveness evaluations. The team also aims to better define patient selection and treatment pathways.

“While surgery remains necessary when malignancy is suspected or in extensive multinodular disease, minimally invasive approaches such as RFA may play an increasingly important role in the management of symptomatic benign nodules,” Dr. Reddy said.