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Laser ablation for the treatment of nonfunctioning benign thyroid nodules: a single center, 10-year retrospective
Roberto Negro1,2, Gabriele Greco3, Miloš Žarković4
1Department of Experimental Medicine. University of Salento, Lecce, Italy. dr.negro@libero.it.
Purpose:
To evaluate the outcomes of symptomatic nonfunctioning benign thyroid nodules treated with laser ablation (LA) over a 10-year follow-up.
Methods:
This retrospective study included patients treated with LA between January 2010 and December 2014 and followed for 10 years. The patient's nodule volume was recorded at baseline, after 6 months, and then annually from the date of the LA procedure. We assessed the volume reduction ratio (VRR), technique efficacy, regrowth rate, additional treatments (surgery or LA), and complications.
Results:
One hundred nine patients were included in the study cohort. The 1-year VRR was 56.3%; technique efficacy was detected in 76 of 109 patients (69.7%). Sixty-nine out of 109 (63.3%) patients did not require a second treatment (LA or surgery) and these 69/109 (63.3%) patients showed a stable VRR of 65%. Regrowth was observed in 28 of 109 (25.7%) patients. EU-TIRADS 2 category, intranodular vascularity, and delivered energy ≥500 J/mL prevented technique inefficacy, regrowth, and retreatment (LA or surgery). Transient complications occurred in 3 out of 109 (2.7%) patients.
Conclusion:
In this 10-year follow-up study, benign thyroid nodules submitted to LA experienced a stable VRR of 65% in more than 60% of patients. To maximize VRR and technique efficacy, LA should be particularly used in EU-TIRADS 2 nodules with intranodular vascularity that should preferably receive ≥ 500 J/mL of energy.
