Thyroid nodules treated with percutaneous radiofrequency thermal ablation: a comparative study
V. Ramundo1, F. Fonderico1, A. Assanti2, F. Marciello1, M. Del Prete1, V. Marotta1, G. Lombardi1, C. Misso1, L. Marzano1, A. Colao1, S. Spiezia2 & A. Faggiano1,3
Author affiliations
1“Federico II” University of Naples, Naples, Italy; 2“Incurabili” Hospital ASL Napoli 1 centro, Naples, Italy; 3National Cancer Institute, “Fondazione G. Pascale”, Naples, Italy.
Introduction: Percutaneous radiofrequency thermal ablation (RTA) is a new promising therapeutic approach to manage compressive thyroid nodules (TNs).
Aim: To investigate effectiveness and safety of RTA in the treatment of compressive TNs in patients not receiving surgery or radioiodine.
Study design: Forty patients (31–86 years) with compressive TNs were enrolled. Twenty-two patients had non-toxic TNs and 18 had toxic TNs and were treated with methimazole. Patients were randomized in two groups: group A (20 patients: 12 non-toxic, 8 toxic TNs) were treated with RTA; group B (20 patients: 10 non-toxic, 10 toxic TNs) did not receive any treatment. There was no significantly different characteristics between groups. RTA was performed by using a RITA© Starburst needle under ultrasonographic guidance. All patients were clinically, biochemically and morphologically evaluated 1, 3 and 6 months after baseline.
Results: At baseline, TN volume was 13.3±8.0 ml in group A and 11.3±6.9 ml in group B (P=NS). After treatment, TN volume significantly decreased in group A (P<0.0001), both in patients with non-toxic TNs and in those with toxic TNs, while remained stable in all patients of group B (P=NS). At 3 and 6 month evaluation, TN volume was significantly lower in group A than in group B (P<0.0001). At the end of the follow-up, pressure symptoms were improved in all patients of group A while persisted unchanged in group B. In the subgroup of patients with toxic TNs, hyperthyroidism completely recovered in 40% and improved in 40% of group A, while it persisted unchanged in all patients of group B. RTA was safe and well tolerated in all patients.
Conclusions: RTA significantly decreases toxic and non-toxic TN volume, resulting in parallel improvement of pressure symptoms and hyperthyroidism. RTA represents a valid therapeutic approach in patients with TNs not receiving conventional treatments.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector