Retrospective study (2020–2025) of 71 adult patients with symptomatic or hyperfunctioning benign thyroid nodules evaluated for RFA, comparing clinical trajectories — including ultimate management, nodule volume reduction, and thyroid function — between self-referred and provider-referred patients.
54% of patients (37/71) underwent RFA; self-referred patients were more likely to have functional nodules (OR 7.88 [1.3–47.4], p=0.03) but chose observation or surgery just as often as RFA (42%/16%/42%). Median VRR at 6–12 months was similar between self- and provider-referred groups (54% vs. 56%, p=0.66), and 100% of patients with hyperfunctioning nodules were euthyroid at 6–12 months post-ablation.
- Small sample size (n=71) limits statistical power and generalizability. - Single-center retrospective design introduces selection bias. - Short follow-up window (6–12 months) may miss late recurrence or delayed thyroid dysfunction.
When endocrine surgeons offer RFA alongside surgery and observation, self-referred patients can receive individualized, evidence-based counseling — and outcomes appear equivalent regardless of referral source. All patients with hyperfunctioning nodules who underwent RFA achieved euthyroidism by 6–12 months, supporting RFA as an effective non-surgical option in this population.
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