Safety and Efficacy of Single-Session Radiofrequency Ablation Treatment for Benign Non-toxic Multinodular Goiter.

Abstract

Radiofrequency ablation (RFA) is an effective treatment for benign thyroid nodules. However, it remains unclear if ablating multiple nodules in single-session offers comparable safety and efficacy to ablating single nodule. Our study compared early complication rate and 6-month nodule shrinkage between multiple-nodules ablation and single-nodule ablation by RFA. Among the 174 eligible patients undergoing RFA of one or more benign thyroid nodules, 85 (48.8%) had single-nodule ablation (group I) while 89 (51.1%) had two or three nodules ablation (group II). The 6-month nodule shrinkage of each nodule (by volume reduction ratio) (VRR) was calculated by (Baseline volume - volume at 6-month)/(Baseline volume)*100 and compared between two groups. To determine independent predictors for VRR, a multivariate analysis was done by logistic regression analysis. Patients in group II reported significantly higher pain scores during and 2-h after treatment than group I (42.31 vs. 29.66, p = 0.029 and 38.21 vs. 26.18, p = 0.037, respectively). Two vocal cord paresis occurred in each group. 3- and 6-month VRR of the largest nodule were comparable between two groups (67.39% vs. 63.89%, p = 0.248 and 77.29% vs. 73.38%, p = 0.182). Similar 3- and 6-month VRR were observed for 2 and 3 largest nodules in group II. In multivariate analysis, total energy given per nodule volume (OR = 1.007, 95% CI = 1.001-1.012, p = 0.036) was the only independent predictor for 6-month VRR. In the presence of multinodular goiter, ablating two or more nodules by RFA within one session appears to offer a comparable level of safety and efficacy to ablating single nodule.