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Dobnig, H; Amrein, K.
Mid- to Long-term Outcomes After Single Radiofrequency Ablation of Non-Toxic and Toxic Thyroid Nodules.
J Clin Endocrinol Metab. 2025; Doi: 10.1210/clinem/dgaf611
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Leading authors Med Uni Graz: Dobnig Harald
Co-authors Med Uni Graz: Amrein Karin
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Abstract:: OBJECTIVE: To evaluate the mid- to long-term recurrence rates after a single radiofrequency ablation (RFA) of benign thyroid adenomas. DESIGN: Retrospective review of data collected in a standardized prospective database. SETTING: Single-center thyroid clinic in Austria. PARTICIPANTS: 896 consecutive patients with either non-toxic nodules (N=765) or toxic adenomas (N=131). INTERVENTION: Mono- or bipolar RFA under local anesthesia. MAIN OUTCOME MEASURES: Recurrence defined as increase in nodule size after RFA treatment by ≥50% from its smallest volume (non-toxic adenomas) or relapse of hyperthyroidism (toxic adenomas). RESULTS: Follow-up periods of 3 years or more were available for 437 non-toxic and 58 toxic adenomas. The median baseline volume was 10.1 ml (IQR 5.5-20) for non-toxic and 7.2 ml (IQR 4.2-14.3) for toxic nodules. Solid or predominantly solid nodules comprised 81 and 93%, respectively. After 1, 3, and 5 years, the average nodule volume decreased by 79%, 82%, and 86% for non-toxic and by 84%, 88%, and 89% for toxic nodules, remaining stable afterwards.In 54 patients (7.1%) with non-toxic nodules regrowth occurred, with a cumulative incidence rate of 17.3% over a maximum of 8 years. Among 15 patients (11.5%) with toxic adenomas, recurrence of hyperthyroidism was observed over 7 years (21.6% cumulative incidence). Fourteen of these patients became euthyroid after low-dose radioiodine treatment (N=11) or a second RFA (N=3). Documented complications included 2.3% moderate and 0.3% severe cases. CONCLUSIONS: In our cohort a single RFA treatment resulted in favorable mid- to long-term outcomes in 83% of non-toxic and 78% of toxic adenoma patients, with an acceptable complication rate.