Radiofrequency Ablation for Solitary Autonomously Functioning Thyroid Nodules: Multicenter Study from Latin America.

Area of Science:

• Endocrinology
• Minimally Invasive Procedures
• Oncology

Background:

• Autonomously functioning thyroid nodules (AFTNs) account for approximately 5% of thyroid nodules, often requiring invasive treatments like surgery or radioiodine (¹³¹I) therapy, which carry risks.
• Radiofrequency ablation (RFA) presents a safer and effective alternative for managing AFTNs, with growing evidence supporting its use.

Purpose of the Study:

• To evaluate the efficacy and safety of radiofrequency ablation (RFA) as a treatment for solitary autonomously functioning thyroid nodules (AFTNs).
• To assess treatment outcomes across multiple centers in Latin America, analyzing nodule volume reduction and hyperthyroidism resolution rates.

Main Methods:

• A retrospective, observational, multicenter cohort study involving 81 patients with histologically confirmed benign solitary AFTNs treated with a single RFA session.
• Data collected included patient demographics, nodule sonographic characteristics, thyroid function tests, clinical symptoms, and nodule volume reduction over 12 months.
• Bivariate analysis was performed to identify factors associated with hyperthyroidism resolution.

Main Results:

• Radiofrequency ablation (RFA) achieved a significant nodule volume reduction ratio (VRR), reaching a median of -90.2% at 12 months.
• Hyperthyroidism resolved in 93.8% of patients, with 58.02% normalizing thyrotropin levels within 1 month post-RFA.
• Complications were infrequent (6.2%), with transient dysphonia being the most common (3.7%); no major complications directly related to RFA were reported.

Conclusions:

• Radiofrequency ablation (RFA) is a safe and effective treatment for solitary autonomously functioning thyroid nodules (AFTNs), demonstrating high rates of hyperthyroidism resolution and significant nodule shrinkage.
• Treatment success, indicated by hyperthyroidism resolution, was associated with a VRR of at least 50% at 6 months, irrespective of baseline nodule characteristics.
• RFA offers a promising, minimally invasive therapeutic option for AFTNs, suitable for a wide range of patients.