A comparison of laser with radiofrequency ablation for the treatment of benign thyroid nodules: a propensity score matching analysis

reserved18Purpose: To compare technique efficacy and safety of laser ablation (LA) and radiofrequency ablation (RFA) in treatment of benign thyroid nodules.Materials and methods: Institutional review board approval was obtained, and patients' consent was waived. 601 nodules were treated from May 2009 to December 2014 at eight centres, 449 (309 females, age 5714years) with LA and 152 (107 females, age 5714years) with RFA. A matched cohort composed of 138 patients from each group was selected after adjustment with propensity score matching. Factors influencing volume reduction at 6 and 12months and complications were evaluated.Results: No significant differences were observed in the baseline characteristics between groups after propensity score matching adjustment. Mean nodule reduction at 6 and 12months was -67 +/- 19% vs. -57 +/- 21% (p<0.001)-70 +/- 19% vs. -62 +/- 22% (p =0.001) in LA group and in RFA group, respectively. Nodules with volume>30mL had significantly higher percentage volume reduction at 6 and 12months (-69 +/- 19 vs. -50 +/- 21, p=0.001) and (-73 +/- 18 vs. -54 +/- 23 8, p=0.001) in the LA group than in the RFA group, respectively. In both groups, operator's skills affected the results. Major complications occurred in 4 cases in each group (p=0.116)Conclusions: LA and RFA showed nearly similar outcome but LA was slightly more effective than RFA in large nodules. Operator's skills could be crucial in determining the extent of nodule volume reduction regardless of the used technique.mixedPacella, Claudio Maurizio; Mauri, Giovanni; Cesareo, Roberto; Paqualini, Valerio; Cianni, Roberto; De Feo, Pierpaolo; Gambelunghe, Giovanni; Raggiunti, Bruno; Tina, Doris; Deandrea, Maurilio; Limone, Pier Paolo; Mormile, Alberto; Giusti, Massimo; Oddo, Silvia; Achille, Gaetano; Di Stasio, Enrico; Misischi, Irene; Papini, EnricoPacella, Claudio Maurizio; Mauri, Giovanni; Cesareo, Roberto; Paqualini, Valerio; Cianni, Roberto; De Feo, Pierpaolo; Gambelunghe, Giovanni; Raggiunti, Bruno; Tina, Doris; Deandrea, Maurilio; Limone, Pier Paolo; Mormile, Alberto; Giusti, Massimo; Oddo, Silvia; Achille, Gaetano; Di Stasio, Enrico; Misischi, Irene; Papini, Enric

Radiofrequency ablation for thyroid nodules: which indications? The first Italian opinion statement

Nodular thyroid disease is a very common finding in clinical practice, discovered by ultrasound (US) in about 50 % of the general population, with higher prevalence in women and in the elderly [1–4]. Whereas therapeutic flowchart is quite established and shared for malignant lesions, multiple options are now available for patients presenting with benign thyroid nod- ules, ranging from simple clinical and US follow-up to thyroid surgery. The majority of thyroid nodules, benign by fine-needle aspiration, are asymptomatic, stable, or slow- growing over time and require no treatmen