title: Thyroid nodules treated with percutaneous radiofrequency thermal ablation: a comparative study.
abstract: OBJECTIVE
  Percutaneous radiofrequency thermal ablation (RTA) was reported as an effective tool for the management of thyroid nodules (TNs). The aim of this study was to investigate the effects of RTA and to establish whether they were treatment-related by comparison with a matched, untreated control group.
  
  
  METHODS
  The study population included 40 patients with compressive TNs: 22 had nontoxic TNs, and 18 had toxic TNs and were treated with methimazole. In all patients, a fine-needle aspiration cytology was performed to exclude a thyroid malignancy.
  
  
  METHODS
  Twenty patients were treated with RTA (group A), and 20 others did not receive any treatment (group B). At baseline, age, gender, and TN features did not differ significantly between groups. All patients were clinically, biochemically, and morphologically evaluated at baseline and after 1, 3, 6, and 12 months.
  
  
  RESULTS
  TN volume significantly decreased in group A (1.8 ± 0.3 ml at 12 months vs. 13.3 ± 1.8 ml at baseline; P < 0.0001) and remained stable in group B [11.7 ± 1.5 ml at 12 months vs. 11.2 ± 1.5 ml at baseline; P = not significant (NS)]. At 3-, 6-, and 12-month evaluations, TN volume was significantly lower in group A than in group B (P < 0.005). At the end of the follow-up, pressure symptoms were improved in all patients in group A but persisted unchanged in group B. In group A, hyperthyroidism completely recovered in 40% and improved in 40% of patients with toxic TNs, whereas it persisted in all patients with toxic TNs in group B. RTA was safe and well tolerated in all patients.
  
  
  CONCLUSIONS
  RTA induced a marked TN volume shrinkage resulting in parallel improvement of pressure symptoms. In most patients with toxic TNs, hyperthyroidism significantly improved as well. RTA may represent a valid therapeutic approach in patients with TNs not receiving conventional treatments.
authors.affiliation: Department of Molecular and Clinical Endocrinology and Oncology, Federico II University of Naples, Via Sergio Pansini 5, 80131 Naples, Italy. afaggian@unina.it
authors.forename: A
authors.initials: A
authors.lastname: Faggiano
authors.forename: V
authors.initials: V
authors.lastname: Ramundo
authors.forename: A P
authors.initials: AP
authors.lastname: Assanti
authors.forename: F
authors.initials: F
authors.lastname: Fonderico
authors.forename: P E
authors.initials: PE
authors.lastname: Macchia
authors.forename: C
authors.initials: C
authors.lastname: Misso
authors.forename: F
authors.initials: F
authors.lastname: Marciello
authors.forename: V
authors.initials: V
authors.lastname: Marotta
authors.forename: M
authors.initials: M
authors.lastname: Del Prete
authors.forename: E
authors.initials: E
authors.lastname: Papini
authors.forename: G
authors.initials: G
authors.lastname: Lombardi
authors.forename: A
authors.initials: A
authors.lastname: Colao
authors.forename: S
authors.initials: S
authors.lastname: Spiezia
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D013956:Antithyroid Agents / Q000627:therapeutic use; D044963:Biopsy, Fine-Needle; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D016555:Matched-Pair Analysis; D008713:Methimazole / Q000627:therapeutic use; D008875:Middle Aged; D016606:Thyroid Nodule / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013971:Thyrotoxicosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery; D016896:Treatment Outcome; D047368:Tumor Burden; D014463:Ultrasonography
chemical_list: D013956:Antithyroid Agents; D008713:Methimazole