Comparing Radiofrequency and Laser Ablation for Thyroid Nodule Volume Reduction

After careful consideration, the Endocrine Society canceled its annual meeting (ENDO 2020), which was set to take place in San Francisco, California, from March 28 to 31, 2020, because of concerns regarding coronavirus disease 2019 (COVID-19). Research findings that were scheduled to be presented at the meeting have been published in a supplemental issue of the Journal of the Endocrine Society. The society is hosting ENDO Online, a complimentary virtual event featuring on-demand and live programming, from June 8 to 22, 2020, to provide a platform for continued learning and research exhibition. For more information, visit the Endocrine Society’s website.

Radiofrequency ablation (RFA) and laser ablation are both safe and very effective for reducing the volume of thyroid nodules, according to study results intended to be presented at the annual meeting of the Endocrine Society (ENDO 2020).

No direct prospective studies have previously compared the safety and efficacy of RFA and laser ablation; therefore, the objective of this study was to compare these techniques in patients with benign nonfunctioning thyroid nodules.

Researchers evaluated 60 patients with a solitary benign nonfunctioning thyroid nodules or a dominant nodule who had pressure symptoms or cosmetic problems, as well as patients without symptoms who experienced a volume increase of >20% in 1 year. Core needle biopsy was performed on all nodules, with an average volume of 25 mL across the study population. Patients were randomly assigned 1:1 to receive either RFA or laser ablation. The primary endpoint was the difference in nodule volume reduction in both groups.

At 6 months, patients who received RFA had a nodule volume reduction of 64.3% (95% CI, 57.5-71.2) and patients who received laser ablation had a reduction of 53.2% (95% CI, 47.2-59.2; P =.015). Symptoms and cosmetic scores improved in both groups and these improvements were not statistically different between the procedures (compressive symptom scores, 2.13 vs 3.9 for RFA [P <.001] and 2.4 vs 3.87 for laser ablation [P <.001]; cosmetic score, 1.65 vs 2.2 for RFA [P <.001] and 1.85 vs 2.2 for laser ablation [P <.001]).

No statistical differences were observed between the groups regarding treatment success rate or thyrotropin levels at 6 months. The rates of adverse events were 37% for RFA and 43% for laser ablation and no patients required hospitalization.

Overall, RFA and laser ablation produced similar success rates at 6 months after treatment in patients with benign nonfunctioning thyroid nodules.

Disclosure: One study author declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Cesareo R, Pacella CM, Pasqualini V, et al. Laser ablation versus radiofrequency ablation for benign non-functioning thyroid nodules: six-month results of a randomised, parallel, open-label, trial (Lara Trial). J Endocr Soc. 2020;4(suppl 1):OR18-07.

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