Efficacy and safety of a single radiofrequency ablation of solid benign non-functioning thyroid nodules

Abstract

Objective: The objective of our study is to evaluate the clinical outcomes and safety of radiofrequency thermal ablation (RFA) for benign thyroid nodules (BTNs) over a 1-year follow-up. Subjects and methods: This is a monocentric retrospective study. Forty-eight patients with solid, non-functioning BTNs were treated by RFA using a 17G internally cooled electrode. We categorized thyroid nodules as small (≤ 12 mL), medium (12 to 30 mL), or large (over 30 mL). BTNs volume reduction, thyroid function, cosmetic and compressive score changes and side effect evaluation at 6 and 12 months were evaluated. Results: BTN volume decreased significantly from baseline to 6 (mean percentage decrease of BTN volume was 66.8 ± 13.6%, p < 0.001). At 12 months, the mean percentage reduction of BTN volume compared to six months was 13.7 ± 17.1% (p < 0.001). At 6-month, symptom score had improved significantly (p < 0.001) while it does not change significantly between 6 and 12 months. In particular, symptom score improved significantly in the medium (p < 0.001) and large (p < 0.01) subgroups. Cosmetic score improved significantly between baseline and 6 months (p < 0.001) and between 6 and 12 months (p < 0.01). In all the subgroups, cosmetic score improved significantly between baseline and 6 months, while between 6 and 12 months it improved significantly only in the large group (p < 0.05). RFA was well tolerated. Only one patient experienced permanent right paramedian vocal cord palsy. Conclusions: A single RFA treatment was effective in reducing BTNs volume, in particular small and medium nodules. Cosmetic score improved in all treated BTNs while symptom score only got better in the medium and large BTNs. Arch Endocrinol Metab. 2017;61(2):173-9.

Radiofrequency ablation for the management of thyroid nodules: A critical appraisal of the literature

“…RFA appears to be an effective nonsurgical option to improve pressure and cosmetic symptoms in benign TNs. Several reports and prospective randomized trials have shown significant nodule volume reduction (50% to 80% compared to the baseline volume and according to the single studies) . At the moment, a common consensus regarding the definition of small, medium and large nodule has not been established.…”

Safety and efficacy of thermal ablation (radiofrequency and laser): should we treat all types of thyroid nodules?

“…Thermal ablation is already used in clinical practice for primary and metastatic malignant liver, breast, renal, bone and lung tumors [20][21][22][23] but is not yet regularly used for TNs, despite their validation in Korean and Italian studies [24][25][26][27][28]. Radiofrequency ablation (RFA), and laser ablation have already been studied separately for the treatment of benign TNs [29][30][31][32][33][34] and in many retrospective and some prospective comparative studies with a long-term follow-up. Currently, RFA and laser ablation are considered effective for treating medium-large solid or cystic nodules (>10 ml) [35][36][37][38] with similar results in compared studies [35].…”

Risk Assessment and Hydrodissection Technique for Radiofrequency Ablation of Thyroid Benign Nodules

“…In recent years, radiofrequency ablation technology has been widely used in minimally invasive of thyroid nodules due to its multiple advantages, such as minimally invasive, simple operation, controllability of the ablation range, stable and reliable 3 , 4 , 20 . Numerous studies have shown that radiofrequency ablation is a safe and reliable treatment for benign thyroid nodules and recurrent thyroid cancer 3 , 4 , 20 . However, it still has a certain incidence of complications because of the complex adjacent structure, such as recurrent laryngeal nerve 5 , 9 .…”

“…Radiofrequency ablation (RFA) has been widely used in the treatment of thyroid nodules, and it has been confirmed to be effective and safe 3 , 4 . However, due to the small size, and complex adjacent structures of the thyroid gland, there is still a certain rate of complications occurred during ablation.…”