Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2007) 14 P383

ECE2007 Poster Presentations (1) (659 abstracts)

Efficacy and safety of radiofrequency thermal ablation in the treatment of thyroid nodules with pressure symptoms in elderly patients

Antongiulio Faggiano 1 , Carolina Di Somma 1 , Francesco Milone 1 , Valeria Ramundo 1 , Gaetano Lombardi 1 , Annamaria Coloa 1 & Stefano Spiezia 2

1Dept. Of Molecular And Clinical Endocrinology And Oncology, ‘Federico Ii’ University Of Naples, Naples, Italy; 2Unit Of Ultrasound-Guided And Neck Pathologies Surgery, ‘Sm Del Popolo Degli Incurabili’ Hospital, Naples, Italy.

Background: Nodular goiter is one of the commonest endocrinopathy. Its incidence increases with age accounting for more than 50% of subjects older than 60 years. Elderly subjects more frequently suffer from pressure symptoms. Loco-regional treatments, like laser photocoagulation and percutaneous ethanol injection, are a potentially useful tool to treat TNs but their efficacy is still debated. Radiofrequency thermal ablation (RTA) has been applied to several benign and malignant tumors proving to be a safe procedure, potentially helpful to stabilize or decrease tumor growth. Recently, RTA proved to be safe and to induce short-time effects in the treatment of patients with thyroid nodules.

Objective: The aim of this study is to evaluate safety and efficacy of RTA in elderly patients with compressive thyroid nodules followed-up for 1 year.

Patients and methods: Thirty-nine elderly patients with cytologically benign compressive TNs were enrolled in the study. Twenty-seven of them were affected with nontoxic goiter, five with pre-toxic goiter, four with toxic goiter, three with toxic adenoma. Thyroid surgery was contraindicated in 22 and refused in 17 cases. RTA was performed by using a RITA © Starbust needle inserted under ultrasonographic real time guide. Efficacy and safety of RTA were followed-up at 1, 3, 6, 12 month.

Results: After treatment, all TNs showed a significant decrease during the follow-up. Mean TN volume decreased from 24.3±2.6 to 6.4±1.6 ml (P<0.001) with a mean percent decrease of 78.6±2.5% 12 months after RTA. Compressive symptoms improved in all cases and disappeared in 82%. The treatment was well tolerated by all patients. No major complications were observed.

Conclusions: RTA seems to be a valid and safe approach in the treatment of benign thyroid nodules with pressure symptoms. RTA may be of great benefit in elderly patients in whom surgery or radio-iodine therapy are contraindicated or refused.

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