Efficacy of Microwave Ablation in the Treatment of Large (≥3 cm) Benign Thyroid Nodules

• Published in: World journal of surgery 2020-07, Vol.44 (7), p.2272-2279
• Main Authors: Khanh, Huynh Quang, Hung, Ngo Quoc, Vinh, Vu Huu, Khoi, Nguyen Van, Vuong, Nguyen Lam
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Ablation; Ablation Techniques - methods; Adult; Benign; Cardiac Surgery; Complications; Female; Follow-Up Studies; General Surgery; Humans; Male; Medicine; Medicine & Public Health; Microwave ablation; Microwaves - therapeutic use; Middle Aged; Nodules; Original Scientific Report; Patients; Retrospective Studies; Safety; Surgery; Thoracic Surgery; Thyroid; Thyroid gland; Thyroid Nodule - diagnostic imaging; Thyroid Nodule - pathology; Thyroid Nodule - surgery; Treatment Outcome; Ultrasonography, Interventional; Ultrasound; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-020-05432-2

Background Large (≥3 cm) benign thyroid nodules usually cause clinical symptoms or cosmetic concerns and therefore require treatment. Microwave ablation (MWA) is a potential valid non-surgical treatment alternative, but there is a lack of evidence. Thus, this study is to evaluate the safety and efficacy of MWA in the treatment of large benign thyroid nodules. Methods A retrospective study was conducted on 42 large benign thyroid nodules in 40 patients treated with MWA. We used the trans-isthmic approach and moving-shot technique to perform the procedure under ultrasound (US) guidance. Patients were followed by clinical and US examinations at 1, 3, 6, and 12 months after the MWA. Study outcomes were complications, volume reduction ratio (VRR), symptom and cosmetic scores, and the requirement of multiple MWA sessions. Results There were 31 females and 9 males, with a median age of 46 years. The medians of largest diameter and volume of the nodules were 40 mm and 22 ml. Four (10%) minor complications were observed. The mean VRR was 75.1, 85.2, and 96.4% after 3, 6, and 12 months. The mean symptom and cosmetic scores dropped from 8.0 and 3.8 (before treatment) to 2.8 and 2.3 (at 12 months), respectively. Thirteen nodules (31%) required two MWA sessions. Conclusions MWA is safe, effective, and can be a good option to treat large benign thyroid nodules. More studies with large dataset and long follow-up are required to improve its safety and efficacy.