Percutaneous Laser Ablation for Thyroid Nodules: Efficacy and Safety in 1492 Patients With Median Follow-up of 10 Years or More.

Abstract

Previous studies have shown the efficacy and safety of percutaneous laser ablation for the treatment of nontoxic and toxic benign thyroid nodules; however, data on long-term follow-up are limited. This work aimed to evaluate the long-term efficacy and safety of percutaneous, ultrasound-guided laser ablation of benign thyroid nodules. Between May 2009 and July 2024, 1492 patients underwent a single treatment with laser ablation (nontoxic nodules, N = 1291; toxic nodules, N = 201 [211 nodules]). Nodule volume was assessed before treatment, then every 6 months in the first 3 years and annually thereafter. Median durations of follow-up were 10.4 years (range, 1-18 years) for nontoxic nodules and 11.4 years (range, 3-15 years) for toxic nodules. For nontoxic nodules, median volume reduction (VRR) was 70.7% at 1 year, reducing to 64.1% at 10 years. For toxic nodules, the corresponding VRR values were 63.8% and 56.9%, respectively (P < .001 vs pretreatment at all time points). No cases of benign nodule regrowth of 25% or greater occurred during the first 3 years of follow-up. The percentage of patients discontinuing methimazole treatment decreased with increasing nodule volume, from 100% for nodules smaller than 5 mL to 33.3% for nodules larger than 25 mL. No major complications were reported; overall, minor complications consisted of fever (15% of patients), pain (7%), and hematoma (1%). In the largest cohorts reported to date, ultrasound-guided laser ablation of thyroid lesions showed long-term efficacy and safety for treatment of nontoxic and toxic nodules, based on median follow-ups of 10 years or more.