Microwave ablation versus surgery for benign thyroid nodules based on composition: A multi-center and prospective study

To evaluate the efficacy of microwave ablation (MWA) for benign thyroid nodules (BTNs) based on composition and compare complications and procedure conditions with surgery for BTNs. 181 patients (MWA: 92; Surgery: 89) with BTNs were enrolled and followed up at the 1st, 3rd, 6th, 12th month. Efficacy contains volume reduction rate (VRR) and technique efficacy (VRR >50 %) during follow-up periods. Cosmetic scores, Hamilton Anxiety Rating Scale (HAMA), visual analog scale (VAS) scores, thyroid functions, complications and other procedure conditions were also compared between the two groups. The VRRs at the 12th month after ablation of nodules with solid portion <10 %, 10 % ≤ solid portion <50 %, 50 % ≤ solid portion <95 % and solid portion ≥95 % were 97.51 %, 90.35 %, 65.12 % and 61.52 %, respectively. Cosmetic scores and HAMA scores in the surgery group were higher than those in the MWA group. VAS scores of surgery group were significantly higher than that of MWA on the day after treatment. Only thyroid-stimulating hormone (TSH) levels of surgery were significantly higher than baseline at the 1st, 3rd, 6th month. The incidence of complications in the two groups were similar. For cystic mainly nodules (solid portion <10 %, 10 % ≤ solid potion <50 %), MWA could be an alternative treatment option. For solid mainly nodules (50 % ≤ solid portion <95 %, solid portion ≥95 %), MWA could be another selection for patients who are intolerant to surgery, have high cosmetic requirements, and are in an anxious state.