Clinical study on the relationship between the incidence of complications and tumour size after thermal ablation of benign thyroid nodules.

Abstract

Objective: The present study aimed to analyze the relationship between the incidence of complications and tumor size following thermal ablation of benign thyroid nodules (BTNs).

Methods: In this retrospective study, 1198 patients who underwent thermal ablation for unifocal BTN were enrolled. Receiver Operating Characteristic analysis was performed to select the cutoff values of the maximum diameter (MD) for dividing patients into different groups or subgroups. Multivariable logistic regression was performed to identify the risk factors. Propensity score matching (PSM) was employed to control for confounding variables.

Results: The overall complication rate was 3.8% (45/1198). Major complications included hoarseness (2.4%), nodule rupture (0.3%) and delayed hemorrhage (0.1%), whereas minor complications were limited to intraoperative hemorrhage (0.9%). The difference in the overall complication rate between the smaller group (< 3.15 cm) and the larger group (> 3.15 cm) was significant (1.0% vs. 6.5%, p < 0.001). In the subgroup analysis, a significant difference was observed between the 3.15-4.15 cm and > 4.15 cm subgroups (4.2% vs. 8.7%, p = 0.023); however, no significant difference was identified between the < 2.35 and 2.35-3.15 cm subgroups (0.6% vs. 1.6%, p = 0.390). Multivariable logistic regression indicated that MD and the nodule component were associated with complications. After PSM, no significant difference in complication rates was observed between MWA and RFA in either the smaller group (p = 1.000) or the larger group (p = 0.186).

Conclusions: The incidence of complications in thermal ablation is greater for larger thyroid nodules, particularly for predominantly solid nodules with MDs greater than 3.15 cm.