2. Laboratory Medicine Service of IRCSS AOU San Martino University-IST, Genoa, Italy.
Background: Many studies have reported mean reductions in nodule volumes and described improvements in the sense of pressure and aesthetic symptoms after radiofrequency ablation. The aim of our study was to document changes in quality of life by means of a 13-scale questionnaire named ThyPRO in a cohort of patients treated with radiofrequency ablation for benign thyroid nodules. Moreover, we assessed the efficacy and safety of the procedure and correlations between efficacy and some features both of the treated nodules and of patients, and evaluated improvements in neck discomfort by means of a visual analogic scale.
Methods: 32 patients with benign thyroid nodules were treated with radiofrequency ablation. We evaluated nodule volume, thyroid function and autoimmunity before and after procedures, adverse events during and after procedures, changes in neck discomfort by means of a visual analogic scale and changes in quality of life through the ThyPRO questionnaire at 1, 3, 6 12, 24 and 36 months. We sought correlations between response to radiofrequency ablation and some features of procedures and patients. We divided patients into 2 groups, according to their mean percentage of nodule volume reduction: group 1 (reduction >30%) and group 2 (reduction <30%) to evaluate whether ThyPRO questionnaire scores changed in patients in whom thyroid RFA was more effective.
Results: At the last evaluation, nodule volume reduction was 45±9 in group 1, 11±9 in group 2 and 40±25% in the total population. We found a correlation between better volume reduction and greater patient age. Thyroid function and autoimmunity were not modified. Adverse events were few and mild. Visual analogic scale scores improved, though scores on the individual ThyPRO scales did not change, even in group 1. The general subjective impact of thyroid disease on quality of life improved from the 3rd month onwards.
Conclusions: In our cohort of patients, quality of life, as evaluated through ThyPRO, did not improve after radiofrequency for benign thyroid nodules. In the literature, changes in quality of life in patients treated with radiofrequency ablation for thyroid nodules have been described in only one paper, while changes in quality of life assessed by means of ThyPRO have never been described.
Keywords: Quality of life, radiofrequency ablation, benign thyroid nodules, thyroid