Long-Term Comparison of US-guided Microwave Ablation Combined with Ethanol Injection versus Surgery for Nodular Retrosternal Goiter
In brief
For retrosternal goiter, ablation complications were 2.2% versus 34.8% with surgery
In a matched retrospective comparison of 448 patients followed for a median of 48 months, microwave ablation plus ethanol injection had similar treatment success to surgery: 98.7% versus 100%. Both relieved symptoms, while ablation was linked to fewer complications and shorter hospital stays, procedures, and incisions. Whether these results hold in broader patient groups remains unclear.
- Journal
- Radiology (Q1)
- Published
- 1 November 2026
- Study design
- Cohort / observational study
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Ying-Ying Li, Ming-Bo Zhang, Lin Yan, Jing Xiao, Xin-Yang Li, Zhen Yang, et al.
- PMID
- 42975303
- DOI
- 10.1148/radiol.253228
Why clinicians should know about it
- Picked for Breast and Endocrine Surgery (paper of the day, 6 November 2026): Long-term comparative study of goiter ablation versus surgery
Abstract
Background Microwave ablation (MWA) combined with ethanol injection (EI) is a minimally invasive technique under preliminary investigation for the treatment of nodular retrosternal goiter (RSG) and has shown promising treatment efficacy. However, a comparative analysis between ablation and surgery is warranted to draw definitive conclusions. Purpose To compare the long-term efficacy and safety of MWA combined with EI versus surgery for patients with nodular RSG. Materials and Methods This retrospective study included patients with nodular RSG treated with MWA combined with EI or surgery between October 2016 and June 2024. Propensity score matching was performed for patients in the ablation and surgery groups, followed by comparisons between the two groups with independent-sample t test, Mann-Whitney U test, χ2, or Fisher exact test. Primary outcomes were treatment success, symptom score, and complication rate. Secondary outcomes were cosmetic score, hospitalization, procedure time, estimated blood loss, incision length, and cost. Results This study included 555 patients (mean age ± SD, 51 years ± 14.4; 414 women). After propensity score matching, 224 patients in the ablation group and 224 patients in the surgery group were observed for a median of 48 months (IQR, 24-60 months). No evidence of a difference was observed in the treatment success rates between the ablation and surgery group (98.7% [221 of 224] vs 100% [224 of 224], respectively; P = .08), while both modalities effectively lowered symptom scores from baseline (both P < .001). Compared with surgery, MWA resulted in a lower complication rate (2.2% [five of 224] vs 34.8% [78 of 224], P < .001), shorter posttreatment hospitalization (P < .001), shorter procedure time (P < .001), reduced estimated blood loss (P < .001), shorter incision length (P < .001), lower cost (P < .001), and lower cosmetic score (mean, 1.1 ± 0.3 vs 1.2 ± 0.4; P = .03) at the 12-month follow-up. Conclusion MWA combined with EI was as effective as surgery for nodular RSGs, providing comparable symptom relief while demonstrating fewer complications, offering a safer alternative for eligible patients. © RSNA, 2026 Supplemental material is available for this article.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.