Long-term Efficacy of Ultrasound-Guided Laser Ablation for Benign Solid Thyroid Nodules. Results of a Three-Year Multicenter Prospective Randomized Trial

• DOI: 10.1210/jc.2014-1826
• Publication Date: 2014-07-22T15:57:47Z
• Authors: E. Papini; T. Rago; G. Gambelunghe; R. Valcavi; G. Bizzarri; P. Vitti; P. De Feo; F. Riganti; I. Misischi; E. Di Stasio; C. M. Pacella
• Keywords: Thyroid Nodules; Nodule (geology); Tolerability

The aim of the present trial on ultrasound (US)-guided laser ablation therapy (LAT) solid thyroid nodules is to assess long-term clinical efficacy, side effects, and predictability outcomes in different centers operating with same procedure.Two hundred consecutive patients were randomly assigned a single LAT session (group 1, 101 cases) or follow-up 2, 99 at four referral centers. Entry criteria were: nodule volume 6-17 mL, repeat benign cytological findings, normal function, no autoimmunity, gland treatment.Group 1: was performed two optical fibers, 1064 nm Nd-YAG source, an output power 3 W. Volume local symptom changes evaluated 6, 12, 24, 36 months after LAT. Side effects tolerability treatment registered. Group 2: Follow-up treatment.One patient lost each group. decrease -49 ± 22%, -59 -60 24%, -57 25% months, respectively (P < .001 vs baseline). resulted reduction >50% 67.3% cases .001). Local symptoms decreased from 38 8% = .002) cosmetic signs 72 16% Baseline size, presence goiter .55), US findings (fluid component ≤ 20% [P .84], halo .46], vascularization .98], calcifications .06]) not predictive factors > 50%. procedure well tolerated most (92%) cases. No function autoimmunity observed. In group increased (25 42%; P .04). efficacy similar centers.A results significant persistent improvement, absence changes.