AUTHOR=Shi Yi-Fan , Zhou Ping , Zhao Yong-Feng , Liu Wen-Gang , Tian Shuang-Ming , Liang Yong-Ping 

TITLE=Microwave Ablation Compared With Laser Ablation for Treating Benign Thyroid Nodules in a Propensity-Score Matching Study

JOURNAL=Frontiers in Endocrinology

VOLUME=Volume 10 - 2019

YEAR=2019

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2019.00874

DOI=10.3389/fendo.2019.00874

ISSN=1664-2392

ABSTRACT=Objective: The efficacy and safety of percutaneous ultrasound-guided microwave and laser ablation(MWA and LA, respectively), for treating benign thyroid nodules (BTNs), were retrospectively compared.
Methods: Patients (n = 318) underwent ablation of 328 BTNs. Confounding bias was reduced by propensity-score matching, and finally the MWA and LA groups each comprised 160 nodules. At baseline (before ablation), 3, 6, and 12 months, and every 6 months thereafter, the following were recorded: nodule volume reduction rate (VRR), neck symptom scores, cosmetic scores, complications and side effects.
Results: The baseline characteristics of the MWA and LA groups were comparable. The volumes of all nodules were less at all follow-ups relative to the baseline, as were the symptom and cosmetic scores at postoperative 6 months and thereafter (P < 0.01). At each follow-up, the overall VRRs of the MWA and LA groups were comparable. However, for nodules ≥13 mL, the VRR associated with LA at ≥6 months was significantly greater than that of MWA. The average ablation time for MWA was less than that of LA (P < 0.01). The overall incidences of major complications, minor complications, and side effects were 1.6%, 2.2%, and 18.4%, respectively, and there were no significant differences between the MWA and LA groups.
Conclusion: Percutaneous ultrasound-guided LA and MWA are safe and effective for the treatment of BTNs. Each can significantly reduce the nodule volume and improve the neck symptoms and appearance of patients, with a low incidence of adverse side effects. The efficiency of MWA is higher than that of LA. For nodules ≥13 mL, MWA may be preferred, but at 6 months and subsequent follow-ups the reduction in volume was greater in patients receiving LA.