Image-guided laser ablation therapy is a rapid outpatient procedure that effectively reduces nodule volume and improves symptoms of benign thyroid nodules, according to data published in the Journal of Clinical Endocrinology & Metabolism.
Although laser ablation therapy for management of benign thyroid nodules has demonstrated favorable results, currently available data are generally limited by the prospective nature and strict enrollment criteria of the trials. Therefore, a better picture of the efficacy and potential complications of the procedure in real practice is necessary, researchers noted.
In this retrospective, multicenter study, the researchers evaluated clinical records of 1,534 consecutive laser-treated nodules in 1,531 patients from eight Italian centers. Inclusion criteria were solid or mixed nodules with fluid component up to 40%, benign cytological findings and normal thyroid function.
Laser ablation therapy was performed with a fixed-power protocol, though number of applicators and illumination times differed according to target size. During the same session, one to three illuminations with pullback technique and total energy delivery based on nodule volume were performed.
Evaluations occurred during laser ablation therapy and within 30 days and 12 months after treatment.
A total of 1,837 treatments were performed, and 83% of nodules had a single session. Results revealed a decrease in mean nodule volume from 27 mL at baseline to 8 mL at 12 months (P<.001), with mean nodule volume reduction being 72%. This was significantly greater in mixed nodules (79%), the researchers reported.
Symptom improvement was also noted, with the percentage of cases experiencing symptoms decreasing from 49% to 10% (P<.001) and the percentage of cases with evidence of cosmetic signs decreasing from 86% to 8% (P<.001).
Seventeen complications occurred, as well as nine minor complications. Eight patients experienced transitory voice changes, but these resolved within 2 to 84 days. Neither thyroid function nor autoimmunity was reported.
“In light of the data provided by this study and of the robust evidence of two decades of literature, laser thermal ablation is confirmed as a clinically effective, well-tolerated, and safe minimally invasive technology for nonsurgical management of symptomatic benign thyroid lesions,” the researchers wrote.