Abstract
BackgroundThe patient satisfaction of symptoms improvement and disease factors that may affect long-term treatment efficacy of radiofrequency ablation (RFA) for non-functioning solid benign thyroid nodules (TNs) over a 2-year follow up study was investigated.MethodsThis retrospective study evaluated 194 non-functioning solid benign TNs of 103 patients. The TNs were categorized as small (≤5 ml), medium (5.1 to 13 ml), intermediate (13.1 to 30 ml) and large (over 30 ml) according to the initial volume of TNs before ablation. Clinical evaluation and contrast-enhanced ultrasound (CEUS) were carried out before ablation and the follow up at 1, 3, 6 months and every 6 months after ablation. All patients were asked to assess the cosmetic score (1–4 scores) and symptom score (0–10 scores) before ablation and every follow up after ablation.ResultsAll patients underwent RFA without any major complications. The mean treatment sessions were 1.5 ± 0.6. 98 nodules required a single session (98/194, 50.5%), 87 required two sessions (87/194, 44.9%), 9 required three sessions (9/194, 4.6%). The average follow up months were 16.3 ± 5.6 (range, 6–24 months) and no nodule regrew in our study. After RFA treatment, the TNs volume significantly decreased (P < 0.001). The small group of nodules shrunk larger compared to the medium, intermediate and large groups (P < 0.001). Cosmetic signs and pressure symptoms were significantly improved, particularly in the intermediate and large groups (P < 0.05).ConclusionsRFA is effective for treating non-functioning solid benign TNs and controlling clinical symptoms with a low complication rate during 2 years follow up. The reduction rate was related to the initial volume of nodules. Patients were satisfied with cosmetic signs and pressure symptoms improvement, particularly in the intermediate and large groups. However, multiple RFA treatments should be used in larger nodules to achieve the desired clinical outcomes.
Highlights
The patient satisfaction of symptoms improvement and disease factors that may affect long-term treatment efficacy of radiofrequency ablation (RFA) for non-functioning solid benign thyroid nodules (TNs) over a 2year follow up study was investigated
Research demonstrated that TNs diagnosed by ultrasound guided core needle biopsy (CNB) as benign nodules may be diagnosed as malignant nodules by postoperative pathology, of which the probability is 6% [4]
Patients enrolled in this study were based on the following criteria: (a) pathological diagnosis was benign by ultrasound guided CNB of thyroid nodule; (b) TNs with solid portion over 80%; (c) thyroid stimulating hormone (TSH), anti-thyroid antibodies and free T3/T4 within the normal range; (d) patients with normal electrocardiogram (ECG) and chest X-ray; (e) patients reported foreign body sensation, compression symptom and local uplift affection due to large volume of nodules, and worries of nodules growing rapidly or malignant lesions; (f) refusal or ineligible for surgery; (g) patients voluntarily receive RFA after being informed of the treatment features of RFA
Summary
The patient satisfaction of symptoms improvement and disease factors that may affect long-term treatment efficacy of radiofrequency ablation (RFA) for non-functioning solid benign thyroid nodules (TNs) over a 2year follow up study was investigated. Research demonstrated that TNs diagnosed by ultrasound guided core needle biopsy (CNB) as benign nodules may be diagnosed as malignant nodules by postoperative pathology, of which the probability is 6% [4]. Symptomatic benign TNs and suspicious malignant TNs should be actively treated [5, 6]. Traditional surgery can remove the symptomatic thyroid nodule and reduce the possibility for malignancy change. Due to several surgical drawbacks and ineligibility, minimally invasive non-surgical technologies have been required in treating TNs [9]
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