Thyroid No surgery 101: Symptoms Resolved after thyroid nodule RF two year follow up.
- Ninety-four elderly patients with cytologically benign compressive TNs were prospectively enrolled in the study; 66 of them had nontoxic goiter and 28 had toxic or pretoxic goiter.
- Mean percent decrease of nodule size was 78.6 ± 2.0%.
- Two years after RF, a 79.4 ± 2.5% decrease of TNs size was observed.
- Compressive symptoms decreased in all and disappeared in 88%.
- Hyperthyroidism resolved in most patients allowing methimazole therapy to be completely withdrawn in 79%.
- Patients with pretoxic (100%).
- Only 53% with toxic TNs).
- No patient needed hospitalization after RTA and no major complications were observed.
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Thyroid Nodules and Related Symptoms Are Stably Controlled Two Years After Radiofrequency Thermal Ablation
- Stefano Spiezia et al
Background: Percutaneous radiofrequency thermal ablation (RTA) is a promising new therapeutic approach to manage thyroid nodules (TNs). The aim of this study was to investigate the long-term effectiveness of RTA in inducing shrinkage of TNs as well as in controlling compressive symptoms and thyroid hyperfunction in a large series of elderly subjects with solid or mainly solid benign TNs.
Methods: Ninety-four elderly patients with cytologically benign compressive TNs were prospectively enrolled in the study; 66 of them had nontoxic goiter and 28 had toxic or pretoxic goiter. RTA was performed by using a RITA© StarBurst Talon hook-umbrella needle inserted in every single TN under ultrasonographic real-time guidance. TN volume, TN-related compressive symptoms and thyroid function were evaluated at baseline and 12 to 24 months after RTA.
Results: All TNs significantly decreased in size after RTA. The mean decrease in TN volume 12 months after RTA was from 24.5 ± 2.1 to 7.5 ± 1.2 mL (p < 0.001), with a mean percent decrease of 78.6 ± 2.0%. Two years after RTA, a 79.4 ± 2.5% decrease of TNs size was observed. Compressive symptoms improved in all patients and completely disappeared in 83 of 94 (88%) patients. Hyperthyroidism resolved in most patients allowing methimazole therapy to be completely withdrawn in 79% of patients with pretoxic and toxic TNs (100% with pretoxic TNs and 53% with toxic TNs). The treatment was well tolerated by all patients. No patient needed hospitalization after RTA and no major complications were observed.
Conclusions: RTA is an effective and simple procedure for obtaining lasting shrinkage of TNs, controlling compressive symptoms, and treating thyroid hyperfunction. When performed in experienced medical centers, RTA may be a valid alternative to conventional treatments for nontoxic and pretoxic TNs. It is particularly attractive for elderly people for whom surgery and radioiodine therapy are often contraindicated or ineffective.