Cesareo Roberto, Palermo Andrea, Pasqualini Valerio, Simeoni Carla, Casini Alessandro, Pelle Giuseppe, Manfrini Silvia, Campagna Giuseppe, Cianni Roberto
Department of Internal Medicine "S. M. Goretti" Hospital, Latina, Italy.
Department of Endocrinology, University Campus Bio-Medico, Rome, Italy.
Arch Endocrinol Metab. 2017 Mar-Apr;61(2):173-179. doi: 10.1590/2359-3997000000246. Epub 2017 Feb 13.
The objective of our study is to evaluate the clinical outcomes and safety of radiofrequency thermal ablation (RFA) for benign thyroid nodules (BTNs) over a 1-year follow-up.
This is a monocentric retrospective study. Forty-eight patients with solid, non-functioning BTNs were treated by RFA using a 17G internally cooled electrode. We categorized thyroid nodules as small (≤ 12 mL), medium (12 to 30 mL), or large (over 30 mL). BTNs volume reduction, thyroid function, cosmetic and compressive score changes and side effect evaluation at 6 and 12 months were evaluated.
BTN volume decreased significantly from baseline to 6 (mean percentage decrease of BTN volume was 66.8 ± 13.6%, p < 0.001). At 12 months, the mean percentage reduction of BTN volume compared to six months was 13.7 ± 17.1% (p < 0.001). At 6-month, symptom score had improved significantly (p < 0.001) while it does not change significantly between 6 and 12 months. In particular, symptom score improved significantly in the medium (p < 0.001) and large (p < 0.01) subgroups. Cosmetic score improved significantly between baseline and 6 months (p < 0.001) and between 6 and 12 months (p < 0.01). In all the subgroups, cosmetic score improved significantly between baseline and 6 months, while between 6 and 12 months it improved significantly only in the large group (p < 0.05). RFA was well tolerated. Only one patient experienced permanent right paramedian vocal cord palsy.
A single RFA treatment was effective in reducing BTNs volume, in particular small and medium nodules. Cosmetic score improved in all treated BTNs while symptom score only got better in the medium and large BTNs.
本研究的目的是评估射频热消融(RFA)治疗良性甲状腺结节(BTN)1年随访期的临床疗效和安全性。
这是一项单中心回顾性研究。48例实性、无功能的BTN患者采用17G内部冷却电极进行RFA治疗。我们将甲状腺结节分为小(≤12 mL)、中(12至30 mL)或大(超过30 mL)。评估了BTN体积缩小、甲状腺功能、美容和压迫评分变化以及6个月和12个月时的副作用评估。
BTN体积从基线到6个月显著下降(BTN体积平均百分比下降为66.8±13.6%,p<0.001)。在12个月时,与6个月相比,BTN体积平均百分比下降为13.7±17.1%(p<0.001)。在6个月时,症状评分显著改善(p<0.001),而在6至12个月之间没有显著变化。特别是,中(p<0.001)和大(p<0.01)亚组的症状评分显著改善。美容评分在基线和6个月之间(p<0.001)以及6至12个月之间(p<0.01)显著改善。在所有亚组中,美容评分在基线和6个月之间显著改善,而在6至12个月之间仅在大结节组显著改善(p<0.05)。RFA耐受性良好。只有1例患者出现永久性右侧声带旁正中麻痹。
单次RFA治疗在减少BTN体积方面有效,尤其是中小结节。所有接受治疗的BTN美容评分均有改善,而症状评分仅在中、大BTN中有所改善。