Endocrine Abstracts

Background: During the last decade, radiofrequency ablation (RFA) has emerged as a reliable alternative to surgery for the treatment of benign symptomatic thyroid nodules in terms of effectiveness and safety.

Aim: The aim of this study were: (i) to evaluate the long-term efficacy (5 years) of RFA for the treatment of benign thyroid nodules, in terms oftechnical success and nodule regrowth, and (ii) to identify the predictive factors of technical failure and nodule regrowth.

Materials and methods: 79 patients who underwent RFA for benign symptomatic thyroid nodules were included in this observational retrospective study. All the patients were followed up yearly for 5 years after the procedure. Regrowth was defined as a nodule volume increase greater than 50% as compared to the previously reported smallest volume after the procedure.

Results: Our analyses show that RFA led to a nodule volume reduction of 72% after one year and 76% after five years from the procedure. The technical success rate was 91%, while regrowth rate was 21.4% in 5 years. Nevertheless, in the majority of cases regrowth was not associated with symptom recurrence. Overall, only 12.7% of the patients were retreated after 5 years. In particular, 5 patients underwent surgery (all the nodules resulted benign at the final pathology), while 5 patients underwent a further session of RFA. The nodule volume reduction after one year from the second procedure was still 67%. Our results show that sex was a predictive factor of technical failure; while sex, age (with an inverse correlation), symptoms, and technical failure were predictive of regrowth.

Conclusions: RFA is effective for the treatment of symptomatic benign thyroid nodules. Overall, RFA is associated with a low rate of failures and regrowths requiring further treatments. Neverheless, if a second procedure is needed, it will further decrease nodule volume by 67%. Furthermore, our data suggest that patients should be followed up after the procedure.