Long-term outcome following laser therapy of benign cystic thyroid nodules

H. Dossing, L. Hegedus, F. N. Bennedbak

Research output: Contribution to journalConference abstract in journalResearchpeer-review

Abstract

Laser therapy (LT) is a safe and effective procedure for inducing thyroid nodule necrosis and shrinkage. Here, our aim was to evaluate long-term efficacy of LT in patients with a predominantly cystic benign recurrent thyroid nodule. Eighty-seven euthyroid outpatients (21 men and 46 women; mean age: 48 years; range; 17-82) with a recurrent cytologically benign cystic ( > 2ml cyst-volume) thyroid nodule causing local discomfort were assigned to LT. LT, using one laser fibre, was performed after complete cyst aspiration and under continuous ultrasound (US) - guidance. The output power was 2.0-3.0 W, and mean delivered energy was 1305 J (range; 94-4392 J). Mean treatment duration was 569 sec. (range; 47-1545). 16 patients (14 within 6 months) had surgery after LT. All had benign histology. The mean follow- up for the remaining 71 patients was 50 months (range; 12-134). Pressure symptoms and cosmetic complaints were evaluated on a visual analogue scale (0-10 cm). The overall mean nodule volume in the 71 patients decreased from 12.2 ml (range; 2.3-45.0) to 1.5 ml (range; 0.7-11.0) (p <0.001) at the final evaluation, corresponding to a mean reduction of 82% (range; 14% - 100%). Remission of the cystic part (cyst volume <1 ml) was obtained in 66 of 71 (93%) patients after LT. The mean cyst volume decreased from 9.8 ml (range; 2.0-45.0) to 0.3 ml (range; 0-4.0) (P <000.1), corresponding to a reduction of 95% (range; 43%- 100%). The mean volume of the solid part of the nodule was reduced from 2.6 ml (range; 1.8-15.1) to 1.1 ml (range; 0.5-6.1) (P <0.001). These results correlated with a significant decrease in pressure as well as cosmetic complaints. Thyroid function was unaltered throughout and side effects were restricted to mild local pain. US-guided aspiration and subsequent LT of benign recurrent predominantly cystic thyroid nodules results in a satisfactory longterm clinical response in the majority of patients. It is a safe and well tolerated procedure and significantly reduces long-term recurrence rate, size of the solid portion of the nodule, and nodule related symptoms. LT constitutes a clinically relevant alternative to surgery in such patients.
Original languageEnglish
Article number846
JournalThyroid
Volume25
Issue numberS1
Pages (from-to)A-334
Number of pages1
ISSN1050-7256
DOIs
Publication statusPublished - 2015
EventInternational Thyroid Congress - Walt Disney World Swan and Dolphin Resort, Orlando, United States
Duration: 18. Oct 201523. Oct 2015

Conference

ConferenceInternational Thyroid Congress
LocationWalt Disney World Swan and Dolphin Resort
CountryUnited States
CityOrlando
Period18/10/201523/10/2015

Cite this

Dossing, H. ; Hegedus, L. ; Bennedbak, F. N. / Long-term outcome following laser therapy of benign cystic thyroid nodules. In: Thyroid. 2015 ; Vol. 25, No. S1. pp. A-334.
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title = "Long-term outcome following laser therapy of benign cystic thyroid nodules",
abstract = "Laser therapy (LT) is a safe and effective procedure for inducing thyroid nodule necrosis and shrinkage. Here, our aim was to evaluate long-term efficacy of LT in patients with a predominantly cystic benign recurrent thyroid nodule. Eighty-seven euthyroid outpatients (21 men and 46 women; mean age: 48 years; range; 17-82) with a recurrent cytologically benign cystic ( > 2ml cyst-volume) thyroid nodule causing local discomfort were assigned to LT. LT, using one laser fibre, was performed after complete cyst aspiration and under continuous ultrasound (US) - guidance. The output power was 2.0-3.0 W, and mean delivered energy was 1305 J (range; 94-4392 J). Mean treatment duration was 569 sec. (range; 47-1545). 16 patients (14 within 6 months) had surgery after LT. All had benign histology. The mean follow- up for the remaining 71 patients was 50 months (range; 12-134). Pressure symptoms and cosmetic complaints were evaluated on a visual analogue scale (0-10 cm). The overall mean nodule volume in the 71 patients decreased from 12.2 ml (range; 2.3-45.0) to 1.5 ml (range; 0.7-11.0) (p <0.001) at the final evaluation, corresponding to a mean reduction of 82{\%} (range; 14{\%} - 100{\%}). Remission of the cystic part (cyst volume <1 ml) was obtained in 66 of 71 (93{\%}) patients after LT. The mean cyst volume decreased from 9.8 ml (range; 2.0-45.0) to 0.3 ml (range; 0-4.0) (P <000.1), corresponding to a reduction of 95{\%} (range; 43{\%}- 100{\%}). The mean volume of the solid part of the nodule was reduced from 2.6 ml (range; 1.8-15.1) to 1.1 ml (range; 0.5-6.1) (P <0.001). These results correlated with a significant decrease in pressure as well as cosmetic complaints. Thyroid function was unaltered throughout and side effects were restricted to mild local pain. US-guided aspiration and subsequent LT of benign recurrent predominantly cystic thyroid nodules results in a satisfactory longterm clinical response in the majority of patients. It is a safe and well tolerated procedure and significantly reduces long-term recurrence rate, size of the solid portion of the nodule, and nodule related symptoms. LT constitutes a clinically relevant alternative to surgery in such patients.",
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Long-term outcome following laser therapy of benign cystic thyroid nodules. / Dossing, H.; Hegedus, L.; Bennedbak, F. N.

In: Thyroid, Vol. 25, No. S1, 846, 2015, p. A-334.

Research output: Contribution to journalConference abstract in journalResearchpeer-review

TY - ABST

T1 - Long-term outcome following laser therapy of benign cystic thyroid nodules

AU - Dossing, H.

AU - Hegedus, L.

AU - Bennedbak, F. N.

PY - 2015

Y1 - 2015

N2 - Laser therapy (LT) is a safe and effective procedure for inducing thyroid nodule necrosis and shrinkage. Here, our aim was to evaluate long-term efficacy of LT in patients with a predominantly cystic benign recurrent thyroid nodule. Eighty-seven euthyroid outpatients (21 men and 46 women; mean age: 48 years; range; 17-82) with a recurrent cytologically benign cystic ( > 2ml cyst-volume) thyroid nodule causing local discomfort were assigned to LT. LT, using one laser fibre, was performed after complete cyst aspiration and under continuous ultrasound (US) - guidance. The output power was 2.0-3.0 W, and mean delivered energy was 1305 J (range; 94-4392 J). Mean treatment duration was 569 sec. (range; 47-1545). 16 patients (14 within 6 months) had surgery after LT. All had benign histology. The mean follow- up for the remaining 71 patients was 50 months (range; 12-134). Pressure symptoms and cosmetic complaints were evaluated on a visual analogue scale (0-10 cm). The overall mean nodule volume in the 71 patients decreased from 12.2 ml (range; 2.3-45.0) to 1.5 ml (range; 0.7-11.0) (p <0.001) at the final evaluation, corresponding to a mean reduction of 82% (range; 14% - 100%). Remission of the cystic part (cyst volume <1 ml) was obtained in 66 of 71 (93%) patients after LT. The mean cyst volume decreased from 9.8 ml (range; 2.0-45.0) to 0.3 ml (range; 0-4.0) (P <000.1), corresponding to a reduction of 95% (range; 43%- 100%). The mean volume of the solid part of the nodule was reduced from 2.6 ml (range; 1.8-15.1) to 1.1 ml (range; 0.5-6.1) (P <0.001). These results correlated with a significant decrease in pressure as well as cosmetic complaints. Thyroid function was unaltered throughout and side effects were restricted to mild local pain. US-guided aspiration and subsequent LT of benign recurrent predominantly cystic thyroid nodules results in a satisfactory longterm clinical response in the majority of patients. It is a safe and well tolerated procedure and significantly reduces long-term recurrence rate, size of the solid portion of the nodule, and nodule related symptoms. LT constitutes a clinically relevant alternative to surgery in such patients.

AB - Laser therapy (LT) is a safe and effective procedure for inducing thyroid nodule necrosis and shrinkage. Here, our aim was to evaluate long-term efficacy of LT in patients with a predominantly cystic benign recurrent thyroid nodule. Eighty-seven euthyroid outpatients (21 men and 46 women; mean age: 48 years; range; 17-82) with a recurrent cytologically benign cystic ( > 2ml cyst-volume) thyroid nodule causing local discomfort were assigned to LT. LT, using one laser fibre, was performed after complete cyst aspiration and under continuous ultrasound (US) - guidance. The output power was 2.0-3.0 W, and mean delivered energy was 1305 J (range; 94-4392 J). Mean treatment duration was 569 sec. (range; 47-1545). 16 patients (14 within 6 months) had surgery after LT. All had benign histology. The mean follow- up for the remaining 71 patients was 50 months (range; 12-134). Pressure symptoms and cosmetic complaints were evaluated on a visual analogue scale (0-10 cm). The overall mean nodule volume in the 71 patients decreased from 12.2 ml (range; 2.3-45.0) to 1.5 ml (range; 0.7-11.0) (p <0.001) at the final evaluation, corresponding to a mean reduction of 82% (range; 14% - 100%). Remission of the cystic part (cyst volume <1 ml) was obtained in 66 of 71 (93%) patients after LT. The mean cyst volume decreased from 9.8 ml (range; 2.0-45.0) to 0.3 ml (range; 0-4.0) (P <000.1), corresponding to a reduction of 95% (range; 43%- 100%). The mean volume of the solid part of the nodule was reduced from 2.6 ml (range; 1.8-15.1) to 1.1 ml (range; 0.5-6.1) (P <0.001). These results correlated with a significant decrease in pressure as well as cosmetic complaints. Thyroid function was unaltered throughout and side effects were restricted to mild local pain. US-guided aspiration and subsequent LT of benign recurrent predominantly cystic thyroid nodules results in a satisfactory longterm clinical response in the majority of patients. It is a safe and well tolerated procedure and significantly reduces long-term recurrence rate, size of the solid portion of the nodule, and nodule related symptoms. LT constitutes a clinically relevant alternative to surgery in such patients.

KW - thyroid gland thyroid nodule American low level laser therapy human patient cyst surgery procedures solid laser visual analog scale follow up outpatient female histology recurrence risk treatment duration ultrasound remission aspiration cyst aspiration pa

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DO - 10.1089/thy.2015.29004.abstracts

M3 - Conference abstract in journal

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VL - 25

SP - A-334

JO - Thyroid

JF - Thyroid

SN - 1050-7256

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