Successful radiofrequency ablation strategies for benign thyroid nodules

Lee, Gee Mun; You, Ji Young; Kim, Hoon Yub; Chai, Young Jun; Dionigi, Gianlorenzo; Tufano, Ralph P.

doi:10.1007/s12020-018-1829-4

Cited by 57 publications

(56 citation statements)

References 26 publications

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“…Our analysis did not provide relevant data to support the assumption that CEUS could be a useful tool to predict the final, post-ablation, volumetric reduction. From the analysis of previous studies focused on the use of LA and RFA, data are discordant on the correlation between nodule structure indirectly assessed by US investigation and final nodule volume reductions (11,12,(26)(27)(28)(29). Therefore, to avoid potential confounding, we used a very restrictive criterion enrolling patients only with solid or predominantly solid nodules with a fluid component £20%.…”

Section: Discussionmentioning

confidence: 99%

Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomized, Parallel, Open-Label, Trial (LARA Trial)

Cesareo

Pacella

Pasqualini

et al. 2020

Thyroid

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Background: No direct prospective studies comparing laser ablation (LA) and radiofrequency ablation (RFA) for debulking benign non-functioning thyroid nodules (BNTNs) exist. We aimed at comparing the efficacy and safety of both techniques in patients with solid or predominantly solid BNTN. Methods: This six-month, single-use, randomized, open-label, parallel trial compared the following primary endpoints between the RFA and LA groups six months after treatment: (i) nodule volume reduction expressed as a percentage of nodule volume at baseline; (ii) proportion of nodules with more than 50% reduction (successful rate). We enrolled subjects with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems or patients without symptoms who experienced a volume increase >20% in one year. Nodules underwent core needle biopsy for diagnosis. Patients were randomly assigned (1:1) to receive LA or RFA. Safety was assessed in all randomly assigned participants. Results: Sixty patients were randomly assigned to receive either RFA or LA (1:1) between January 2016 and November 2018. Both groups were similar in basal nodule volume, thyroid function, histology, symptoms/ cosmetic score, and procedure time. At six months, the nodule volume reduction was 64.3% (95% confidence interval, CI 57.5-71.2) in the RFA group and 53.2% ([CI 47.2-95.2]; p = 0.02) in the LA group. This effect was also confirmed in the linear regression model adjusted for age, baseline volume, and proportion of cellular component (LA vs. RFA percent change Delta =-12.8, p = 0.02). No significant difference was observed in success rate six months after treatment (RFA vs. LA: 86.7% vs. 66.7%, p = 0.13) or in thyrotropin level between the groups. Although improved, no significant difference was observed between RFA and LA for compressive symptoms (RFA: 2.13 vs. 3.9, p < 0 $ 001; LA: 2.4 vs. 3.87, p < 0.001) and cosmetic score (RFA: 1.65 vs. 2.2, p < 0.001; LA: 1.85 vs. 2.2, p < 0.001). The adverse event rates (local pain, dysphonia, thyrotoxicosis, fever, hematoma) were 37% (n = 11) and 43% (n = 13) for RFA and LA, respectively, with no requirement for hospitalization. Conclusion: Although the success rate was similar in the RFA and LA groups, RFA achieved a significantly larger nodule volume reduction at six months.

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Section: Discussionmentioning

confidence: 99%

Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomized, Parallel, Open-Label, Trial (LARA Trial)

Cesareo

Pacella

Pasqualini

et al. 2020

Thyroid

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“…The thermal ablation can reduce the volume of these symptomatic benign nodules between 80% and 90% thus, solving the esthetic or compressive complains. 12 , 16 , 29…”

Section: Discussionmentioning

confidence: 99%

“…Although, cystic nodules will experience an initial abrupt reduction in volume, due to aspiration of liquid, all nodules will have about the same volume reduction rate (VRR) after 6 months. 12 Divergently, predominantly cystic lesion could be effectively treated by Ethanol Ablation (EA) with a fraction of the cost of RFA. As the proportion of the nodules' solid part increases less effective EA is compared to RFA.…”

Section: Benign Lesionsmentioning

confidence: 99%

Radiofrequency for benign and malign thyroid lesions

Rangel

Volpi

Stabenow³

et al. 2020

World j. otorhinolaryngol.-head neck surg.

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Background Thermal ablation of thyroid nodules is new modality for the management of the benign and malign lesions. This minimally invasive treatment is performed as an outpatient, local anesthetic, single professional procedure that can treat neoplastic lesions without removing normal thyroid tissue and thus avoiding hypothyroidism. Method A comprehensive review of the most relevant literature regarding the thermal ablation of benign and malign nodules was performed in order to currently define its role on the management of the nodular thyroid disease. The data was divided into benign and malign literature. Results The benign nodules can be effectively treated by radiofrequency ablation (RFA) but some limitation exists regarding the nodule's size but not nodules characteristics. The RFA of primary malign tumors of the thyroid recently demonstrated positive and safe long-term follow-up and encouraged additional investigation and possibly a definitive role in the management of these low risk nodules. Conclusion RFA is a safe, cost-effective minimally invasive procedure that avoids thyroid tissue removal while destroying neoplastic one thus, preventing hypothyroidism.

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“…Image-guided minimally invasive treatment including percutaneous ethanol injection (PEI), percutaneous laser ablation (PLA), microwave ablation (MWA) and radiofrequency ablation (RFA) [9][10][11], which have been proposed as a first-line treatment for solid nonfunctioning thyroid nodule [12], may solve the anxiety of patients and it may be a way to compensate for image deriving cancer overdiagnosis [13]. Ultrasound-guided radiofrequency ablation (RFA) is an important therapeutic measure for hepatocellular carcinoma (HCC) [14,15] and has yielded good results not only in the treatment of benign thyroid nodule [16,17] but also in the treatment of low-risk PTMC, which have been confirmed by several studies. In addition, our 5-year followup results showed that PTMC patients undergoing RFA have a good lesion reduction rate, few postoperative complications, quite a few recurrence/metastasis rates [18].…”

Section: Introductionmentioning

confidence: 99%

Factors associated with health-related quality of life in papillary thyroid microcarcinoma patients undergoing radiofrequency ablation: a cross-sectional prevalence study

Lan

Jin

Zhang

et al. 2020

International Journal of Hyperthermia

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Purpose: To explore the association of demographic characteristics, clinical symptoms and the fear of the disease progression factors with the physical and mental summary components of the healthrelated of life (HRQoL) of the papillary thyroid microcarcinoma (PTMC) patients undergoing radiofrequency ablation (RFA). Methods: 123 PTMC survivors undergoing RFA were enrolled in this study from October 2019 to March 2020. Demographic, clinical symptoms and the fear of the disease progression data were collected. SF-36, THYCA-QoL and FoP-Q-SF were used to evaluate the HRQoL of patients, clinical symptoms and the fear of disease progression. A multivariate regression model was performed to evaluate the association between the independent variable and the HRQoL variable. Results: The average self-reported HRQoL score was 81.17 ± 15.48 for the PCS and 73.40 ± 18.03 for the MCS. The multivariate linear regression model shows that the factors related to a poorer PCS were dependent for the female patients, the symptoms of neuromuscular and the throat/mouth, the fear of disease progression; the psychological disorder, symptoms of throat/mouth, inability to concentrate were related to worse scores for the MCS. The condition that was most strongly related to a poorer HRQoL (in both PCS and MCS) was the fear of their physical health. Conclusions: The factors related to significantly worse HRQoL scores across PCS and MCS for PTMC survivors include the female gender, the symptoms of neuromuscular and the throat/mouth, the psychological disorder, inability to concentrate, and the fear of their own physical health. Identification, management, and prevention of these factors are critical to improving the HRQoL of patients.

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Successful radiofrequency ablation strategies for benign thyroid nodules

Cited by 57 publications

References 26 publications

Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomized, Parallel, Open-Label, Trial (LARA Trial)

Laser Ablation Versus Radiofrequency Ablation for Benign Non-Functioning Thyroid Nodules: Six-Month Results of a Randomized, Parallel, Open-Label, Trial (LARA Trial)

Radiofrequency for benign and malign thyroid lesions

Factors associated with health-related quality of life in papillary thyroid microcarcinoma patients undergoing radiofrequency ablation: a cross-sectional prevalence study

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