Therapeutics and Clinical Risk Management (Jan 2022)
Efficacy and Safety of Radiofrequency Ablation for the Treatment of Autonomously Functioning Thyroid Nodules: A Long-Term Prospective Study
Abstract
Dang Luu Vu,1 Minh Thong Pham,1 Van Bang Nguyen,2 Thi My Le3 1Bach Mai Radiology Center, Bach Mai Hospital, Hanoi, Vietnam; 2Center of Endocrinology and Diabetes, Family Hospital, Da Nang, Vietnam; 3Radiology Department, Vinmec Times City International Hospital, Hanoi, VietnamCorrespondence: Thi My LeRadiology Department, Vinmec Times City International Hospital, Hanoi, VietnamTel +84 979600233Email [email protected]: This study aims to evaluate the efficacy and safety of RFA in the AFTN treatment after 2 years of follow-up and to find the factors related to treatment responses through TSH level and VRR.Materials and Methods: This long-term prospective study was conducted from September 2017 to April 2021 on 17 AFTNs treated with RFA. Clinical evaluations, thyroid function tests, thyroid scintigraphy, and ultrasonography examinations were performed at 1 month, 3 months, 6 months, and 24 months after ablation. The primary endpoint was the success rate of RFA in restoring the euthyroidism stage after 24 months of follow-ups; secondary outcomes were VRR and improvements of US parameters, clinical examinations, and complications. The Spearman rank correlation test was used to determine related factors with treatment response variables.Results: At the 24 months after the procedure, symptom score, cosmetic score, vascularity grade, and nodule volume significantly decreased. The VRR reduced approximately 42.77%, 63.13%, 78.3%, and 95.65% after 1 month, 3 months, 6 months, and 24 months follow-up. All 17 patients were restored euthyroid state without taking ATDs. No major complications were collected. The last TSH level was significantly correlated with the age of patients (Spearman rho = − 0.637, p = 0.008). The VRR was significantly correlated with age of patients (Spearman rho = 0.566, p = 0.018) and initial TSH (Spearman rho = 0.485, p = 0.048).Conclusion: RFA was demonstrated as a safe and effective option for AFTN treatment in long-term follow-up. It can be used as an alternative treatment with encouraging results.Keywords: radiofrequency ablation, thyroid nodules, autonomously functioning thyroid nodule
