Background Benign thyroid nodules are common, and must be treated when symptomatic. Non-surgical minimally invasive modalities, including radiofrequency ablation (RFA), have been widely used with good results. The factors related to the efficacy of RFA are still debated. This study was to evaluate the safety, efficacy and related factors of RFA in the treatment of benign thyroid nodules. Methods A retrospective single-center study was conducted on 251 benign thyroid nodules in 184 patients treated with RFA. The procedure was performed under ultrasound (US) guidance using the trans-isthmic approach and the moving-shot technique. Clinical and US examinations were performed at 1, 3, 6, 12 months, and then at 6 month intervals. Study outcomes were volume reduction ratio (VRR) and complications. Results There were 153 women and 31 men included in the study. The mean age was 43.9 years. The median initial largest diameter and volume of nodules were 30 mm and 6.18 ml. The median length of follow-up was 12 months. Two minor complications were found. The mean VRR was 66.8; 74.3; and 81% after 3, 6, and 12 months, respectively. Initial solidity was a factor related to the efficacy: cystic nodules had higher VRR compared to solid ones. Conclusions RFA is safe, effective and can be used as a routine treatment for benign thyroid nodules. More prospective multicenter studies with long-term follow-up are required to improve the safety and efficacy of RFA.Authors Nguyen Lam Vuong and Le Quang Dinh have contributed equally to this work.
Background Video-assisted thoracoscopic surgery lobectomy combined with lymphadenectomy is widely utilized worldwide for treating non-small cell lung cancer. We evaluated the long-term survival outcomes of this approach and determined the prognostic factors of overall survival. Methods This prospective observational study was performed in patients with non-small cell lung cancer who were subjected to video-assisted lobectomy and lymphadenectomy from 2012 to 2016. Independent prognostic factors were determined via uni- and multivariable Cox models. Results There were 109 patients with the mean age of 59.2 years and males accounted for 54.1%. Postoperative staging determined 22.9% of stage IA, 31.2% of stage IB, 16.5% of stage IIA and 29.4% of stage IIIA. Median follow-up time was 27 months. The overall survival rate after 1, 2, 3, 4 and 5 years was 100%, 85.9%, 65.3%, 55.9% and 55.9%, respectively. In univariable analysis, smoking (hazard ratio (HR) [95% confidence interval (CI)]: 2.50 [1.18–5.31]), Tumor--nodes--metastases (TNM) stage (IIA: 7.60 [1.57–36.9]; IIIA: 14.3 [3.28–62.7] compared to IA), histological differentiation (moderately differentiated: 4.91 [1.04–23.2]; poorly differentiated: 8.25 [1.91–35.6] compared to well differentiated), lymph node size ≥1 cm (8.22 [3.11–21.7]), tumour size ≥3 cm (4.24 [1.01–17.9]), radical lymphadenectomy (6.67 [3.14–14.2]) were identified as prognostic factors of the long-term survival. In multivariable analysis, only radical lymphadenectomy was an independent prognostic factor (HR [95% CI]: 3.94 [1.41–11.0]). Conclusion Video-assisted thoracoscopic lobectomy combined with lymphadenectomy is feasible, safe and effective for the treatment of non-small cell lung cancer. The long-term outcomes of this method are favourable, especially at the early stage of cancer.
Introduction: Venous malformations are the most common type of vascular malformations. Ethanol sclerotherapy is one of the most commonly used treatment methods. This study is to evaluate the initial results of digital subtraction angiography-guided ethanol sclerotherapy in patients with peripheral venous malformation. Methods: This was a retrospective cohort study of a single centre experience. Patients diagnosed with peripheral venous malformation who underwent digital subtraction angiography-guided ethanol sclerotherapy from Jan 2017 to Jun 2021 were included in the study. Medical records were reviewed to record demographic information, lesion characteristics including clinical and magnetic resonance imaging findings, treatment sessions, therapeutic outcomes, and complications. Results: A total of 104 patients were included. The mean number of procedures was 2.0 ± 1.3 times. Last follow-ups revealed a partial relief of symptoms in 97.2% of patients, and three patient (2.9%) showed no improvement. Post-treatment imaging revealed an overall objective response rate of 93.3%. Early post-procedural minor complications occurred after sclerotherapies in 31.7% of patients and were entirely resolved by conservative means. On multivariate analysis, poorly-defined margin (OR: 10.7, 95% CI: 2.28–76.9) and volume of venous malformation on MRI (OR: 1.04, 95% CI: 1.00–1.11) were independent predictors of “no-good response” to percutaneous ethanol sclerotherapy. Conclusion: Percutaneous sclerotherapy is safe and effective in the treatment of venous malformation. A poor-defined margin and volume of VMs on MRI were statistically significant predictors of the initial percutaneous ethanol sclerotherapy results and may be useful in selecting patients. Highlights
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