Long-Term Outcomes of Thermal Ablation for Benign Thyroid Nodules: The Issue of Regrowth

Abstract

Thermal ablation (TA) for benign thyroid nodules (BTNs) is widely accepted as an effective and safe alternative to surgery. However, studies on the long-term outcomes of TA have reported problems with nodule regrowth and symptom recurrence, which have raised the need for adequate control of regrowth. Therefore, a more complete TA with a longer-lasting treatment effect may be required. In this study, we review and discuss long-term outcomes and regrowth of BTNs following TA and evaluate factors affecting the long-term outcomes. We also discuss the management of regrowth based on long-term outcomes.

Radiofrequency ablation is an effective treatment for Bethesda III thyroid nodules without genetic alterations

“…In the subgroups of patients evaluated at 1 and 2 years, a progressive volume decrease was observed, though a longer follow-up is needed since regrowth from marginal undertreated tissue is frequently reported 2–3 years after RFA ( 18 ). Nevertheless, data at the long follow-up of 2 years, although obtained in a limited number of cases, seem to indicate that the regrowth of this kind of nodules is null or extremely limited.…”

Risk factors of recurrent thyroid nodules after radiofrequency ablation

“…The occurrence of complications is related to the clinician's knowledge and manipulation, and the patient's condition. Whether the clinician is familiar with neck anatomy, ultrasound image interpretation, ablation power adjustment and ablation time control will affect the incidence of complications 29 .…”

Clinical Approach for Thyroid Radiofrequency Ablation

“…고주파 절제술 후 치료 성과는 1년 이내의 단기 성과에서는 50% 이상의 부피 감소, 증상의 완화 등 대부분 좋았다( 1 50 51 52 ). 그러나 3년 이상의 장기 추적검사 결과가 발표되면서 약 20%–30%가량에서 재성장이 있다는 것이 알려지기 시작했다( 40 53 54 ). 결절의 재성장은 주로 합병증의 예방을 위해 남겨 놓은 결절의 주변부, 살아 있는 조직에서 발생한다.…”

“…재성장을 적절히 관리하기 위해서는 어떤 요인들이 재성장에 영향을 미치는지를 파악해야 한다( 55 ). 재성장에 영향을 미치는 요인을 크게 결절인자와 기술적 인자로 나눌 수 있다( 54 ).…”