Safety and Efficacy of Single‐Session Radiofrequency Ablation Treatment for Benign Non‐toxic Multinodular Goiter

• DOI: 10.1007/s00268-022-06527-8
• Publication Date: 2022-03-21T14:36:13Z
• Authors: Brian Hung Hin Lang; Matrix Man Him Fung
• Keywords: Nodule (geology); Thyroid Nodules

AbstractBackgroundRadiofrequency ablation (RFA) is an effective treatment for benign thyroid nodules. However, it remains unclear if ablating multiple nodules in single‐session offers comparable safety and efficacy to ablating single nodule. Our study compared early complication rate and 6‐month nodule shrinkage between multiple‐nodules ablation and single‐nodule ablation by RFA.MethodsAmong the 174 eligible patients undergoing RFA of one or more benign thyroid nodules, 85 (48.8%) had single‐nodule ablation (group I) while 89 (51.1%) had two or three nodules ablation (group II). The 6‐month nodule shrinkage of each nodule (by volume reduction ratio) (VRR) was calculated by (Baseline volume − volume at 6‐month)/(Baseline volume)*100 and compared between two groups. To determine independent predictors for VRR, a multivariate analysis was done by logistic regression analysis.ResultsPatients in group II reported significantly higher pain scores during and 2‐h after treatment than group I (42.31 vs. 29.66, p = 0.029 and 38.21 vs. 26.18, p = 0.037, respectively). Two vocal cord paresis occurred in each group. 3‐ and 6‐month VRR of the largest nodule were comparable between two groups (67.39% vs. 63.89%, p = 0.248 and 77.29% vs. 73.38%, p = 0.182). Similar 3‐ and 6‐month VRR were observed for 2 and 3 largest nodules in group II. In multivariate analysis, total energy given per nodule volume (OR = 1.007, 95% CI = 1.001–1.012, p = 0.036) was the only independent predictor for 6‐month VRR.ConclusionIn the presence of multinodular goiter, ablating two or more nodules by RFA within one session appears to offer a comparable level of safety and efficacy to ablating single nodule.