Title:Unfavorable Outcomes in Solid and Spongiform Thyroid Nodules Treated with Laser Ablation. A 5-Year Follow-up Retrospective Study
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Author(s):Roberto Negro* and Gabriele Greco
Affiliation:Department of Internal Medicine, Division of Endocrinology, “V. Fazzi” Hospital, Piazza F. Muratore, 73100, Lecce, Department of Internal Medicine, Division of Endocrinology, “V. Fazzi” Hospital, Piazza F. Muratore, 73100, Lecce
Keywords:Thyroid, laser, thermal ablation, nodule, ultrasound, surgery.
Abstract:
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.