Conventional thyroidectomy vs thyroid thermal ablation on postoperative quality of life and satisfaction for patients with benign thyroid nodules

in European Journal of Endocrinology
View More View Less
  • 1 The Second Department of General Surgery, Zhuhai People’s Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, Guangdong Province, China
  • | 2 Affiliated Foshan Hospital of Southern Medical University, Foshan, Guangdong Province, China
  • | 3 Zhuhai People’s Hospital (Zhuhai Hospital Affiliated with Jinan University), Zhuhai, Guangdong Province, China

Correspondence should be addressed to H Jin or L Lu or M Cui; Email: 986220192@qq.com or 2771384902@qq.com or haodoctorjin@foxmail.com
Restricted access

Objective

The complications and treatment effects of conventional thyroidectomy and thyroid thermal ablation should be compared in order to identify the best intervention for patients with benign thyroid nodules.

Methods

Patients (18–50 years old) who had benign thyroid nodules and were eligible for both thyroidectomy and thyroid thermal ablation were randomly allocated (1:1) to either conventional thyroidectomy group or thyroid thermal ablation group. Patients’ satisfaction and condition-specific quality of life were measured with the Thyroid-Specific Quality-of-Life Questionnaire Scale (QoL) at the 15th post-randomization month and were set as the co-primary outcome.

Results

A total of 450 patients were enrolled and randomized (225 patients in each group). At the 15th month after randomization, more patients in the thyroid thermal ablation group were satisfied with the treatment effects compared to those in the conventional thyroidectomy group. More patients in the thyroid thermal ablation group have a QoL score of 410 (QOL scores ranges from 0 to 410) than patients in conventional thyroidectomy. Eight (4%) of the 209 patients in conventional thyroidectomy group and 6 (3%) of the 208 patients in thyroid thermal ablation group had at least one severe postoperative complication. The time to achieve volume reduction was longer in the thermal ablation group.

Conclusion

Thyroid thermal ablation is superior to conventional thyroidectomy in terms of patients satisfaction, post-operative quality of life, and shorter hospital stay but takes longer to achieve BTNs volume reduction. The complication rates between the two groups were similar.

 

     European Society of Endocrinology

Sept 2018 onwards Past Year Past 30 Days
Abstract Views 2687 2528 344
Full Text Views 237 190 6
PDF Downloads 198 185 9
  • 1

    Durante C, Grani G, Lamartina L, Filetti S, Mandel SJ & Cooper DS The diagnosis and management of thyroid nodules: a review. JAMA 2018 319 914924. (https://doi.org/10.1001/jama.2018.0898)

    • Search Google Scholar
    • Export Citation
  • 2

    Lee GM, You JY, Kim HY, Chai YJ, Kim HK, Dionigi G & Tufano RP Successful radiofrequency ablation strategies for benign thyroid nodules. Endocrine 2019 64 316321. (https://doi.org/10.1007/s12020-018-1829-4)

    • Search Google Scholar
    • Export Citation
  • 3

    Jin H, Fan J, Liao K, He ZC, Li W & Cui M A propensity score matching study between ultrasound-guided percutaneous microwave ablation and conventional thyroidectomy for benign thyroid nodules treatment. International Journal of Hyperthermia 2018 35 232238. (https://doi.org/10.1080/02656736.2018.1492028)

    • Search Google Scholar
    • Export Citation
  • 4

    Zhang B, Tian J, Pei S, Chen Y, He X, Dong Y, Zhang L, Mo X, Huang W & Cong S et al.Machine learning-assisted system for thyroid nodule diagnosis. Thyroid 2019 29 858867. (https://doi.org/10.1089/thy.2018.0380)

    • Search Google Scholar
    • Export Citation
  • 5

    Parry Z & Macnab R Thyroid disease and thyroid surgery. Anaesthesia and Intensive Care Medicine 2017 18 488495. (https://doi.org/10.1016/j.mpaic.2017.06.015)

    • Search Google Scholar
    • Export Citation
  • 6

    Vorlaender C, Kohlhase KD, Korkusuz Y, Erbelding C, Luboldt W, Baser I & Korkusuz H Comparison between microwave ablation and bipolar radiofrequency ablation in benign thyroid nodules: differences in energy transmission, duration of application and applied shots. International Journal of Hyperthermia 2019 35 216225. (htps://doi.org/10.1080/02656736.2018)

    • Search Google Scholar
    • Export Citation
  • 7

    Korkusuz Y, Groener D, Raczynski N, Relin O, Kingeter Y, Grünwald F & Happel C Thermal ablation of thyroid nodules: are radiofrequency ablation, microwave ablation and high intensity focused ultrasound equally safe and effective methods? European Radiology 2018 28 929935. (https://doi.org/10.1007/s00330-017-5039-x)

    • Search Google Scholar
    • Export Citation
  • 8

    Jongekkasit I, Jitpratoom P, Sasanakietkul T & Anuwong A Transoral endoscopic thyroidectomy for thyroid cancer. Endocrinology and Metabolism Clinics of North America 2019 48 165–180. (https://doi.org/10.1016/j.ecl.2018.11.009)

    • Search Google Scholar
    • Export Citation
  • 9

    Kim JH, Baek JH, Lim HK, Ahn HS, Baek SM, Choi YJ, Choi YJ, Chung SR, Ha EJ & Hahn SY et al.Guideline Committee for the Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology Thyroid Radiofrequency Ablation Guideline. 2017 Thyroid Radiofrequency Ablation Guideline: Korean Society of Thyroid Radiology. Korean Journal of Radiology 2018 19 632655. (https://doi.org/10.3348/kjr.2018.19.4.632)

    • Search Google Scholar
    • Export Citation
  • 10

    Garstka ME, Alameer ES, Al Awwad S & Kandil E Conventional robotic endoscopic thyroidectomy for thyroid cancer. Endocrinology and Metabolism Clinics 2019 48 153–163. (https://doi.org/10.1016/j.ecl.2018.10.005)

    • Search Google Scholar
    • Export Citation
  • 11

    Zhi X, Zhao N, Liu Y, Liu JB, Teng C & Qian L Microwave ablation compared to thyroidectomy to treat benign thyroid nodules. International Journal of Hyperthermia 2018 34 644652. (https://doi.org/10.1080/02656736.2018.1456677)

    • Search Google Scholar
    • Export Citation
  • 12

    Samuels MH, Kolobova I, Smeraglio A, Peters D, Purnell JQ & Schuff KG Effects of levothyroxine replacement or suppressive therapy on energy expenditure and body composition. Thyroid 2016 26 347355. (https://doi.org/10.1089/thy.2015.0345)

    • Search Google Scholar
    • Export Citation
  • 13

    Chung SR, Baek JH, Choi YJ & Lee JH Longer-term outcomes of radiofrequency ablation for locally recurrent papillary thyroid cancer. European Radiology 2019 29 48974903. (https://doi.org/10.1007/s00330-019-06063-5)

    • Search Google Scholar
    • Export Citation
  • 14

    Cheng ZG, Che Y, Yu SY, Wang SR, Teng DK, Xu HX, Li JW, Sun DS, Han ZY & Liang P US-guided percutaneous radiofrequency versus microwave ablation for benign thyroid nodules: a prospective multicenter study. Scientific Reports 2017 7 110. (https://doi.og/10.1038/s41598-017-09930-7)

    • Search Google Scholar
    • Export Citation
  • 15

    Chung SR, Suh CH, Baek JH, Park HS, Choi YJ & Lee JH Safety of radiofrequency ablation of benign thyroid nodules and recurrent thyroid cancers: a systematic review and meta-analysis. International Journal of Hyperthermia 2017 33 920930. (https://doi.org/10.1080/02656736.2017.1337936)

    • Search Google Scholar
    • Export Citation
  • 16

    UK Department of Health and Social Care. Consultant-led treatment: right to start within 2015. (available at: https://www.gov.uk/government/publications/right-to-startconsultant-led-treatment-within-18-weeks). Accessed on 18 Oct 2018.

    • Search Google Scholar
    • Export Citation
  • 17

    legislation.gov.uk. The patient rights (treatment time guarantee) (Scotland) regulations 2012. (available at: http://www.legislation.gov.uk/ssi/2012/110/made). Accessed on 18 Oct 2018.

    • Search Google Scholar
    • Export Citation
  • 18

    Yue WW, Wang SR, Lu F, Sun LP, Guo LH, Zhang YL, Li XL & Xu HX Radiofrequency ablation vs. microwave ablation for patients with benign thyroid nodules: a propensity score matching study. Endocrine 2017 55 485495. (https://doi.org/10.1007/s12020-016-1173-5)

    • Search Google Scholar
    • Export Citation
  • 19

    Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedus L, Duick DS, Guglielmi R, Hamilton CR & Zeiger MA et al.American Association of Clinical Endocrinologists, American College of endocrinology, and associazione medical endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules-2016 update. Endocrine Practice 2016 22 160. (https://doi.org/10.4158/EP161208.GL)

    • Search Google Scholar
    • Export Citation
  • 20

    Papini E, Pacella CM, Misischi I, Guglielmi R, Bizzarri G, Døssing H & Hegedus L The advent of ultrasound-guided ablation techniques in nodular thyroid disease: towards a patient-tailored approach. Best Practice and Research Clinical Endocrinology and Metabolism 2014 28 601618. (https:/doi.or10.1016/j.beem.2014.02.004)

    • Search Google Scholar
    • Export Citation
  • 21

    Cooper KG, Bain C & Parkin DE Comparison of microwave endometrial ablation and transcervical resection of the endometrium for treatment of heavy menstrual loss: a randomised trial. Lancet 1999 354 185918 63. (https://doi.org/10.1016/S0140-6736(9904101-X)

    • Search Google Scholar
    • Export Citation
  • 22

    Cooper K, Breeman S, Scott NW, Scotland G, Clark J, Hawe J, Hawthorn R, Phillips K, MacLennan G & Wileman S et al.Laparoscopic supracervical hysterectomy versus endometrial ablation for women with heavy menstrual bleeding (HEALTH): a parallel-group, open-label, randomised controlled trial. Lancet 2019 394 14251436. (https://doi.org/10.1016/S0140-6736(1931790-8)

    • Search Google Scholar
    • Export Citation
  • 23

    Dow KH, Ferrell BR & Anello C Quality-of-life changes in patients with thyroid cancer after withdrawal of thyroid hormone therapy. Thyroid 1997 7 61361 9. (https://doi.org/10.1089/thy.1997.7.613)

    • Search Google Scholar
    • Export Citation
  • 24

    Ryu CH, Park B, Ryu J, Ryu YM, Jo SA, Lee YJ, Lee EK, Hwangbo Y, Joo J & Jung YS Development and evaluation of a Korean version of a thyroid-specific quality-of-life questionnaire scale in thyroid cancer patients. Cancer Research and Treatment 2018 50 405415. (https://doi.org/10.4143/crt.2017.012)

    • Search Google Scholar
    • Export Citation
  • 25

    NHS Health Research Authority. Safety reporting. (available at: https://www.hra.nhs.uk/approvals-amendments/managing-your-approval/safetyreporting/). Accessed on 14 Aug 2019.

    • Search Google Scholar
    • Export Citation
  • 26

    Shen Y, Liu M, He J, Wu S, Wan YL, Ding J, Cai XY & Fu XH Differences in treatment outcomes between ultrasound-guided percutaneous microwave ablation and endoscopic thyroidectomy for patients with papillary thyroid microcarcinoma: protocol for a systematic review and meta-analysis. Medicine 2019 98 e13953. (https://doi.org/10.1097/MD.0000000000013953)

    • Search Google Scholar
    • Export Citation
  • 27

    Gibelin H, Sierra M, Mothes D, Ingrand P, Levillain P, Jones C, Hadjadj S, Torremocha F, Marechaud R & Barbier J et al.Risk factors for recurrent nodular goiter after thyroidectomy for benign disease: case-control study of 244 patients. World Journal of Surgery 2004 28 10791082. (https://doi.org/10.1007/s00268-004-7607-x)

    • Search Google Scholar
    • Export Citation