Thermal Ablation Vs Thyroidectomy for Large Benign Thyroid Nodules

Inclusion Criteria: * benign thyroid nodules confirmed by surgical pathology in surgery group, and by two separate US-guided fine-needle aspiration (FNA) or core needle biopsy (CNB) in thermal ablation group; * the largest diameter of the nodule ≥4 cm; * the presence of nodule-related symptoms, cosmetic concerns, or psychological stress; * patients treated with surgery, or staged thermal ablation (who explicitly refused surgery); * more than 12-month follow-up duration Exclusion Criteria: * suspicion of malignant nodule on ultrasound findings (e.g., marked hypoechoic, microcalcifications, or ill-defined margins); * comorbidities of other severe diseases; * without complete treatment and/or follow-up information