ECE2021 Audio Eposter Presentations Thyroid (157 abstracts)
Laser ablation versus radiofrequency ablation for benign non-functioning thyroid nodules: twelve-month results of a randomized, parallel-arm, open-label trial
Roberto Cesareo 1 , Silvia Manfrini 2 , Valerio Pasqualini 3 , Cesare Ambrogi 3 , Gianfranco Sanson 4 , Andrea Gallo 5 , Paolo Pozzilli 2 , Claudio Pedone 6 , Anna Crescenzi 7 & Andrea Palermo 2
1”S. M. Goretti” Hospital, Latina, Italy, Unit of metabolic diseases; 2Campus Bio-Medico University, Unit Of Endocrinology, Rome, Italy; 3”S. M. Goretti” Hospital, Latina, Italy, Department of Radiology; 4University of Trieste, Clinical Department of Medical, Surgical and Health Sciences, Trieste, Italy; 5Sapienza University of Rome, Italy, Department of Sense Organs; 6Campus Bio-Medico University, Rome, Italy, Geriatric Unit, Rome, Italy; 7Campus Bio-Medico university, Rome, Italy, Unit of Pathology, Rome, Italy
Background
Radiofrequency ablation (RFA) seems to achieve a significantly larger nodule volume reduction rate (VRR) than laser ablation (LA) in benign non-functioning thyroid nodules (BNTNs). We compared the efficacy and safety of both thermal ablation treatments at the 12-month follow-up in patients with solid or predominantly solid BNTN.
Methods
This 12-month, single-use, randomized open-label parallel trial compared the following primary endpoints between the RFA and LA groups 12 months post-treatment: (a) nodule volume reduction, expressed as a percentage of the nodule volume at baseline and (b) proportion of nodules with more than 50% reduction (technical success rate). We enrolled patients with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems or asymptomatic patients who experienced a volume increase of >20% within 1 year. This trial was registered with ClinicalTrials.gov (NCT02714946).
Results
Sixty patients were randomly assigned (1:1 ratio) to receive either RFA or LA, and 29 patients per group completed the study. Both groups had similar basal nodule volume, thyroid function, histology, and symptoms/cosmetic score, whereas a larger quantity of energy was delivered to patients who underwent RFA. At 12 months, the nodule volume reduction rate was 70.9 ± 16.9% and 60.0 ± 19.0% in the RFA and LA groups, respectively (P = 0.024). This effect was confirmed in the linear regression model that was adjusted for age, sex, and nodule baseline volume and proportion of cellular components (RFA treatment: β = 0.390; P = 0.009). No significant between-group difference was observed in the technical success rate at 12 months post-treatment (RFA: n = 26, 89.7%; LA: n = 22, 75.9%; P = 0.149). A statistically significant improvement was observed from the baseline to the 12-month follow-up for compression (RFA: 4.6 ± 2.6 and 1.3 ± 0.8, P<0.001 and LA: 4.6 ± 2.1 and 1.6 ± 0.8, respectively, P<0.001) and cosmetic (RFA: 3.4 ± 0.6 and 1.3 ± 0.5, P<0.001 and LA: 3.4 ± 0.5 and 1.4 ± 0.6, P<0.001) scores although the between-group differences were not significant.
Conclusion
RFA achieved a significantly larger nodule volume reduction at 12 months; however, the technical success rate was similar in the RFA and LA groups.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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