Quality of life in patients treated with radiofrequency ablation for thyroid nodules

Abstract

Background: Many studies have reported mean reductions in nodule volumes and described improvements in the sense of pressure and aesthetic symptoms after radiofrequency ablation. The aim of our study was to document changes in quality of life by means of a 13-scale questionnaire named ThyPRO in a cohort of patients treated with radiofrequency ablation for benign thyroid nodules. Moreover, we assessed the efficacy and safety of the procedure and correlations between efficacy and some features both of the treated nodules and of patients, and evaluated improvements in neck discomfort by means of a visual analogic scale. Methods: 32 patients with benign thyroid nodules were treated with radiofrequency ablation. We evaluated nodule volume, thyroid function and autoimmunity before and after procedures, adverse events during and after procedures, changes in neck discomfort by means of a visual analogic scale and changes in quality of life through the ThyPRO questionnaire at 1, 3, 6 12, 24 and 36 months. We sought correlations between response to radiofrequency ablation and some features of procedures and patients. We divided patients into 2 groups, according to their mean percentage of nodule volume reduction: group 1 (reduction >30%) and group 2 (reduction <30%) to evaluate whether ThyPRO questionnaire scores changed in patients in whom thyroid RFA was more effective. Results: At the last evaluation, nodule volume reduction was 45±9 in group 1, 11±9 in group 2 and 40±25% in the total population. We found a correlation between better volume reduction and greater patient age. Thyroid function and autoimmunity were not modified. Adverse events were few and mild. Visual analogic scale scores improved, though scores on the individual ThyPRO scales did not change, even in group 1. The general subjective impact of thyroid disease on quality of life improved from the 3rd month onwards. Conclusions: In our cohort of patients, quality of life, as evaluated through ThyPRO, did not improve after radiofrequency for benign thyroid nodules. In the literature, changes in quality of life in patients treated with radiofrequency ablation for thyroid nodules have been described in only one paper, while changes in quality of life assessed by means of ThyPRO have never been described.

Assessment of thyroid-specific quality of life in patients with benign symptomatic thyroid nodules treated with radiofrequency or ethanol ablation: a prospective multicenter study

“…Other symptom scales also improved persistently in both groups. By contrast, a previous study by Oddo et al [ 13 ] reported no significant improvement in QoL scales after RFA, except for the "general score," which improved after 3 months. They explained that the cause of less improvement seemed to have been due to the low VRR, which was <50% in most patients.…”

“…All US systems were equipped with a high-frequency linear probe (5)(6)(7)(8)(9)(10)(11)(12)(13)(14). Three orthogonal diameters, the longest diameter and two perpendicular diameters, were measured, and the volume of each nodule was calculated using the equation as follows: V = πabc/6…”

“…Although many previous studies including randomized clinical trials and meta-analyses have confirmed the effectiveness and safety of these procedures for management of BSTNs [3,[7][8][9], relatively little is known about the effects of these procedures on patient QoL. Regarding the QoL after ablation treatment, several studies [10][11][12] have reported that positive whereas another study by Dr. Oddo [13] have shown opposite results. In addition to causing compressive symptoms and cosmetic problems, thyroid nodules can affect other various aspects of daily life, including the physical, social, and emotional well-being of an individual.…”

Quality of Life in Patients Treated with Percutaneous Laser Ablation for Non-Functioning Benign Thyroid Nodules: A Prospective Single-Center Study

“…Our group recently published a study on changes in QoL, as assessed by means of ThyPRO after RFA of benign thyroid nodules. In that study, we did not find a significant improvement in ThyPRO scales, except for the “general score,” which improved after three months ( 32 ). The cause of less improvement of ThyPRO scales in this study ( 32 ) was probably induced by low volume reduction: the majority of patients showed less than a 50% volume reduction.…”