Predictors of early complete nodule shrinkage in symptomatic benign thyroid nodules treated with radiofrequency ablation with or without sclerotherapy: a retrospective study.

Abstract

Objectives: To identify factors influencing the early complete shrinkage of symptomatic benign thyroid nodules following radiofrequency ablation (RFA) with or without sclerotherapy and to predict complete nodule resolution within 2 years, thereby alleviating concerns regarding long-term follow-up outcomes.

Materials and methods: Patients with symptomatic benign thyroid nodules who underwent RFA were retrospectively enrolled. The patients were grouped according to whether their nodules had completely shrunk within 2 years. Logistic regression analyses were conducted to identify independent prognostic factors associated with early complete shrinkage. These factors were subsequently integrated into predictive nomograms.

Results: A total of 118 patients were included with a mean follow-up of 50.5 months. The complete nodule shrinkage rate at 2 years was 27% (32/118). Independent predictors for complete nodule shrinkage within 2 years included a smaller initial nodule volume (odds ratio (OR), 2.471; 95% confidence interval (CI), 1.516-4.027; p < 0.001), absence of posterior echogenicity enhancement (OR, 10.771; 95% CI, 1.521-76.27; p = 0.017), and reduced perinodular vascularity (OR, 8.912; 95% CI, 2.909-27.303; p < 0.001). The predictive nomogram demonstrated a high predictive value with an area under the curve of 0.9655. Furthermore, in patients receiving lauromacrogol sclerotherapy, a smaller initial nodule volume and reduced use of lauromacrogol were independent predictors.

Conclusion: This study demonstrated the efficacy of RFA in treating symptomatic thyroid nodules and suggested the use of predictive factors and a nomogram to assess early shrinkage, which would facilitate personalized follow-up for patients.

Key points: Question What factors predict early complete shrinkage of symptomatic benign thyroid nodules after radiofrequency ablation. Findings A smaller initial volume, the absence of posterior echogenic enhancement, and reduced perinodular vascularity on ultrasound were predictive of complete shrinkage within 2 years. Clinical relevance This study enabled physicians to better address patients' concerns regarding the pace of nodule shrinkage and the persistence of nodules even after extended periods. This understanding helps alleviate anxiety for both us and patients when determining the follow-up endpoint.