By Chris Berrie
WROCLAW, Poland -- May 7, 2014 -- A single session of ultrasound-guided laser ablation provides significant volume reduction and improvements in local symptoms in patients with benign solid thyroid nodules, compared with no-ablation follow-up, according to a study presented here at the 16th European Congress of Endocrinology (ECE).
A number of single-centre short-term series have indicated that thermal ablation can significantly decrease thyroid nodule volume. However, little is known of the long-term clinical efficacy and side effects of laser ablation of thyroid nodules.
Enrico Papini, MD, Department of Endocrinology, Regina Apostolorum Hospital, Albano Laziale, Italy, and colleagues randomised 201 consecutive patients with solid thyroid nodules (5-10 mL) from 4 different centres to follow-up or to a single ultrasound-guided laser ablation session.
All patients had normal thyroid function, repeat benign cytological findings, no autoimmunity, and no thyroid gland treatment.
The ultrasound-guided laser ablation was carried out in a single session with 2 optical fibres and a neodymium yttrium-aluminium garnet laser source (output power, 3 W). The energy delivery was 3,600 joules for nodules ≤13 mL, and 7,200 joules for those >13 mL.
Patients were evaluated for volume and local symptom changes and side effects at 1, 6, 12, 24, and 36 months from baseline (laser ablation).
At 36 months, the mean nodule volume had significantly increased by 25% in the control group (P = .04), but showed no significant worsening of local symptoms.
For the laser ablation group, there was a mean decrease in nodule volume of 49% at 6 months; 59% at 12 months; 60% and 24 months; and 58% at 36 months (PP = .002).
Laser ablation therapy was well tolerated in 92% of the patients. There was 1 case of vocal cord paresis, which was self-resolved in 2 weeks. There were no changes in thyroid function in any of the patients who received laser ablation.
[Presentation title: Long-Term Efficacy of Ultrasound-Guided Laser Ablation for Solid Thyroid Nodules. A 3-Year Multicentre Prospective Randomized Trial. Abstract P988]
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