Radiofrequency Ablation in the Management of Extensive Multinodular Goiter: A Midterm Single-Center Experience.

PURPOSE: To assess the effectiveness of radiofrequency (RF) ablation in providing cosmetic and symptom relief for patients with extensive multinodular goiter.

MATERIALS AND

METHODS

This retrospective study included 40 patients (175 target nodules, averaging 4 per patient) treated with monopolar RF ablation. Effectiveness was assessed through clinical symptom relief, laboratory tests, and ultrasound (US) monitoring of target and nontarget lesions.

RESULTS

A single RF ablation session was sufficient for 134 nodules (24 patients), whereas 19 additional sessions were performed in 13 patients for 41 additional lesions. Reasons for repeated RF ablation included planned treatment of additional nodules (n = 32, 12 patients), retreatment due to incomplete ablation (n = 6, 4 patients), treatment of growing nontarget lesions (n = 2, 2 patients), and new nodules (n = 1, 1 patient). At the last follow-up (mean, 40.5 months, range, 25-70 months), the mean volume reduction rate was 85.3% (SD ± 12.2). Local symptoms improved from 2.9 (SD ± 2.0) to 0.3 (SD ± 0.8) on a 10-point scale (P < .001), and the mean cosmetic score decreased from 3.6 (SD ± 0.9) to 1.6 (SD ± 0.9) (P < .001). Three patients (7.5%) experienced temporary hoarseness; no other adverse events were reported.

CONCLUSIONS

RF ablation is an effective, repeatable treatment for multinodular goiter, achieving substantial symptom and cosmetic improvement while preventing nodule regrowth and avoiding thyroid surgery in selected patients.