Original ArticlesHealth-Related Quality of Life After Percutaneous Radiofrequency Ablation of Cold, Solid, Benign Thyroid Nodules: A 2-Year Follow-Up Study in 40 Patients
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INTRODUCTION
In 2010, the American Association of Clinical Endocrinologists, the Associazione Medici Endocrinologi, and the European Thyroid Association published medical guidelines for the diagnosis and management of thyroid nodules (TNs) (1). Those guidelines suggested the use of ultrasound (US)-guided percutaneous laser ablation (PLA) for the treatment of solid TNs causing symptoms or cosmetic issues in patients who decline surgery or are at surgical risk. In regards to radiofrequency (RF) ablation
Patients
The study design was retrospective and was approved by the Ethical Committee of the Clinical Cancer Research Institute, Arcispedale Santa Maria Nuova, Reggio Emilia, Italy. Files for 225 patients consecutively treated with RFA between January 2012 and February 2014 at our institution were reviewed. Patients were referred to our Endocrinology Unit by their physicians for the RFA procedure with compressive symptoms: pressure symptoms, throat constraint, and/or swallowing difficulty (n = 43,
RESULTS
All patients underwent a single RFA treatment. Total energy delivered was 37,154 ± 18,092 joules (median, 34,832 joules; range 5,439 to 82,006 joules), and output power was 37.4 ± 8.8 watts (median, 35 watts; range, 20 to 65 watts). RF delivery time was 22.1 ± 10.9 minutes (median, 20.5 minutes; range, 8.2 to 60.0 minutes). There was a correlation between initial nodule volume and total energy administered (rs = 0.698; P<.0001). Nodule volume changes, PCS-12, MCS-12, symptom score, cosmetic score,
DISCUSSION
This is the first study evaluating HRQL modification after RFA for symptomatic solid TNs. The limitation of this study is the retrospective, noncontrolled design. Our study shows that RFA improves HRQL in patients with symptomatic TNs. Moreover, in agreement with other studies, both the self-reported pressure symptoms and the cosmetic complaints improved after RFA. In our experience, RFA was effective in reducing benign TNs by 80% after 2 years. Our data support that a large area of nodular
CONCLUSION
In conclusion, our study confirms that RF ablation of benign TNs is effective in controlling pressure and cosmetic problems and in reducing nodular volume over a 2-year follow-up, without thyroid dysfunction or life-threatening complications. Our data indicate that the achievement of these secondary endpoints is associated with HRQL improvement, measured both by PCS and MCS. Hence, RFA may be considered a valid option for the clinical management of benign TNs.
REFERENCES (40)
- et al.
The advent of ultrasound-guided ablation techniques in nodular thyroid disease: towards a patient-tailored approach
Best Pract Res Clin Endocrinol Metab
(2014) - et al.
Tests of data quality, scaling assumptions, and reliability of the SF-36 in eleven countries: results from the IQOLA Project. International Quality of Life Assessment
J Clin Epidemiol
(1998) - et al.
Crossvalidation of item selection and scoring for the SF-12 Health Survey in nine countries: results from the IQOLA Project. International Quality of Life Assessment
J Clin Epidemiol
(1998) - et al.
Use of structural equation modeling to test the construct validity of the SF-36 Health Survey in ten countries: results from the IQOLA Project. International Quality of Life Assessment
J Clin Epidemiol
(1998) - et al.
Comparison of Rasch and summated rating scales constructed from SF-36 physical functioning items in seven countries: results from the IQOLA Project. International Quality of Life Assessment
J Clin Epidemiol
(1998) - et al.
Crosscultural comparisons of the content of SF-36 translations across 10 countries: results from the IQOLA Project. International Quality of Life Assessment
J Clin Epidemiol
(1998) - et al.
The equivalence of SF-36 summary health scores estimated using standard and country-specific algorithms in 10 countries: results from the IQOLA Project. International Quality of Life Assessment
J Clin Epidemiol
(1998) - et al.
The factor structure of the SF-36 Health Survey in 10 countries: results from the IQOLA Project. International Quality of Life Assessment
J Clin Epidemiol
(1998) - et al.
Society of Interventional Radiology clinical practice guidelines
J Vasc Interv Radiol
(2003) - et al.
US-guided percutaneous radiofrequency thermal ablation for the treatment of solid benign hyperfunctioning or compressive thyroid nodules
Ultrasound Med Biol
(2008)
American Association of Clinical Endocrinologists, Associazione Medici Endocrinologi, and European Thyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules
J Endocrinol Invest
Diagnosis of endocrine disease: thyroid ultrasound (US) and US-assisted procedures: from the shadows into an array of applications
Eur J Endocrinol
Radiofrequency ablation of benign non-functioning thyroid nodules: 4-year follow-up results for 111 patients
Eur Radiol
Single-session treatment of benign cystic thyroid nodules with ethanol versus radiofrequency ablation: a prospective randomized study
Radiology
Thermal ablation for benign thyroid nodules: radiofrequency and laser
Korean J Radiol
Radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: consensus statement and recommendations
Korean J Radiol
Levothyroxine or minimally invasive therapies for benign thyroid nodules
Cochrane Database Syst Rev
Measuring healthrelated quality of life
Ann Intern Med
John E. Ware Jr on health status and quality of life assessment and the next generation of outcomes measurement. Interview by Marcia Stevic and Katie Berry
J Healthc Qual
Percutaneous laser ablation of cold benign thyroid nodules: a 3-year follow-up study in 122 patients
Thyroid
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DISCLOSURE
The authors have no multiplicity of interest to disclose.