Percutaneous Ultrasound-Guided Laser Ablation of Benign Thyroid Nodules: Results of 10-Year Follow-Up in 171 Patients

Abstract

Context: Percutaneous, ultrasound-guided laser ablation is effective in nodular thyroid disease. Objective: The aim of this study was to evaluate the long-term (10-year) efficacy and safety of laser ablation in the treatment of benign thyroid nodules. Methods: From 2009 to 2010, 171 patients received a single session of laser ablation. Evaluation of nodule volume was performed before treatment, at 6 months, and every year. Results: Technique efficacy was achieved in 92% of patients at 1 year. Median nodule volume significantly decreased from 16.7 mL (range, 11.0-97.0 mL) at baseline to 5.0 mL (range, 4.1-32.0 mL) at 1 year, a volume reduction ratio (VRR) of 68%. The benefit of the treatment was durable (P < 0.001 vs baseline at all timepoints), with a VRR of 59% after 10 years. No cases of nodule regrowth > 50% were observed at 1 year, although such cases did occur after 4 years (n = 3; 1.7% of the overall cohort) and 7 years (n = 8; 4.7%). There were no further cases of regrowth beyond 7 years. When patients were stratified according to baseline nodule volume (< 15 mL, 15-25 mL, or > 25 mL), durable results were observed across all 3 categories, with the largest, most prolonged effect observed in patients with nodules < 15 mL. Treatment was well tolerated, with only minor, transient complications of fever and local pain, and 98% of patients willing to recommend the treatment. Conclusion: Percutaneous, ultrasound-guided laser ablation of benign thyroid nodules provides long-term benefits and the treatment is well tolerated.