A Summary of a Study on Radiofrequency & Laser Ablation Published in PubMed
Five-Year Results of Radiofrequency and Laser Ablation of Benign Thyroid Nodules: A Multicenter Study from the Italian Minimally Invasive Treatments of the Thyroid Group
The Background:
Thyroid Radiofrequency ablation, also known as thyroid RFA, and laser ablation (LA) are clinically proven new minimally invasive alternatives to surgical procedures. As these medical imaging equipment and procedures are relatively new to clinical practices, there are limited long-term follow-up studies. This particular study was aimed at evaluating the technique efficiency, rate of regrowth, and retreatment over five (5) years after RFA or LA procedures took place to identify predictive factors of the outcomes of these procedures.
The Methods:
The methods used for the comparative study were the following:
- 406 patients treated with either thyroid radiofrequency ablation or laser ablation and followed for 5 years after initial treatment
- Cumulative incidence studies with hazard models were used to describe regrowth and retreatment trends and to identify prognostic factors.
- Logistic regression models and receiver operating characteristics analyses were used for risk factors and their cut-offs.
You may read the more detailed information in the published study cited below.
The Results:
The results of the comparative analysis were that Thyroid Radiofrequency Ablation and Laser Ablation procedures significantly reduced benign thyroid volume that was maintained over a five (5) year period.
- The technique efficacy (reduction ≥ 50% after 1 year from the treatment) was achieved in 74% of patients (85% in the thyroid RFA and 63% in the LA group)
- Regrowth occurred in 28% of patients (20% in the thyroid RFA and 38% in the LA group)
- In the majority of cases, further treatment was not required
- Only 18% of patients were retreated (12% in the RFA and 24% in the LA group)
- The studies showed that RFA was associated with a lower risk of regrowth and a lower risk of requiring retreatment over time.
- Overall, technique inefficacy and regrowth were associated with low energy delivery
- Retreatments were more frequent in young patients, in large nodules, in patients with lower volume reduction at 1-year, and in cases of low energy delivery (optimal cut-off was 918 J/mL for RFA)
A few miscellaneous, yet very important, facts from the study are:
- Regrowth was observed in 20% of patients treated with thyroid radiofrequency ablation (43/216) and in 38% of patients treated with Laser Ablation (72/190)
- The vast majority of patients (82%) did not receive any further treatment after the first thyroid ablation, while 18% (72/406) underwent a second procedure.
- Of the RFA group, 12% of patients (26/216) were retreated.
- Of the LA group, 24% of patients (46/190) were retreated.
- A median volume reduction of 44% after 1 year from the retreatment
Conclusion:
Considering all of the facts, you can see that the risk of regrowth and the need for retreatment were much lower after thyroid radiofrequency ablation. Moreover, the need for retreatment was more so associated with younger aged individuals, with a larger baseline volume, and treatment with low energy delivery.
You can access the originally published Comparative Study here.
Citation:
Bernardi S, Giudici F, Cesareo R, Antonelli G, Cavallaro M, Deandrea M, Giusti M, Mormile A, Negro R, Palermo A, Papini E, Pasqualini V, Raggiunti B, Rossi D, Sconfienza LM, Solbiati L, Spiezia S, Tina D, Vera L, Stacul F, Mauri G. Five-Year Results of Radiofrequency and Laser Ablation of Benign Thyroid Nodules: A Multicenter Study from the Italian Minimally Invasive Treatments of the Thyroid Group. Thyroid. 2020 Dec;30(12):1759-1770. doi: 10.1089/thy.2020.0202. Epub 2020 Jul 24. PMID: 32578498.
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