Objective: Laser Ablation (LA) is a therapeutic modality for reducing the volume of large
benign thyroid nodules. This retrospective study was aimed at assessing the outcome of LA in patients
with benign nonfunctioning thyroid nodules in a 5-years follow-up.
Methods: Sixty-two patients (47 females; mean age 54.7±12 yr) with benign cold thyroid nodules underwent
LA from July 2009 to March 2012. Nodule volume, thyroid function test, and ultrasound were
monitored at baseline, and at 3, 6 and 12 months after the procedure, then annually. After dividing
nodules in solid and spongiform, we evaluated unfavourable outcomes: 1) nodule’s volume reduction
<50%; 2) need for surgery; 3) need for additive LA session (due to nodule re-growth with persistence
of cosmetic concern or compressive symptoms).
Results: Baseline volume did not differ between solid and spongiform nodules as well as energy delivered
and the number of needles used. Unfavourable outcomes occurred in 24 patients (38.7%). Nineteen/
24 (79.2%) patients who experienced unfavourable outcomes belonged to the solid nodules group
(P<0.01). When considering only those who benefited from LA, the 5-years reduction was 59.7% for
solid and 78.6% for spongiform nodules (P<0.05). One/6 patients who underwent surgery (solid nodules
group) had a final diagnosis of Follicular Variant of Papillary Thyroid Cancer (FVPTC).
Conclusion: Large solid nodules, unlike spongiform, submitted to LA are characterized by a long-term
unfavourable outcome and entail a potential risk of false negative cytologic results.