Radiofrequency Ablation as a Safe and Effective Treatment for Thyroid Nodules After Lobectomy.

Abstract

A new symptomatic nodule may develop or a preexisting nodule may grow to warrant treatment in the remaining lobe of patients who previously had a unilateral thyroid lobectomy. Conventional management often results in completion thyroidectomy, but radiofrequency ablation (RFA) offers a minimally invasive alternative to surgical resection. We evaluated the safety and efficacy of RFA in treating these cases. This retrospective study included 47 patients with a history of thyroid lobectomy who underwent RFA for thyroid nodules in the contralateral lobe. Eight patients had a history of papillary thyroid carcinoma (PTC), 25 had hyperfunctioning nodules, and 14 had symptomatic thyroid nodules. Primary outcomes were the volume reduction ratio (VRR) at 3 months, 6 months, and final follow-up. Secondary outcomes were post-RFA complications and maintenance of thyroid function. Median VRR at final follow-up was 81.0% [IQR: 58%-89%]. Complete disappearance was achieved in 6.4% of patients, while progression was observed in 2.1% of cases during follow-up. Post-RFA complications were minimal, with three patients experiencing temporary vocal cord paresis and two patients reporting post-procedure discomfort/pain. No other complications were observed. No patient experienced a change in baseline thyroid function, and no new cases of hypothyroidism or hyperthyroidism occurred. RFA is a safe and effective alternative to completion thyroidectomy for remaining thyroid nodules in post-lobectomy patients. RFA allows clinically meaningful volume reduction while maintaining a low complication rate in the hands of an experienced operator.