Laser Ablation versus Radiofrequency Ablation for thyroid nodules: Twelve-month results of a randomized trial (LARA II study)

CONTEXT: Radiofrequency ablation (RFA) seems to achieve a significantly larger nodule volume reduction rate (VRR) than laser ablation (LA) in benign non-functioning thyroid nodules (BNTNs).OBJECTIVE: To compare the efficacy and safety of both treatments at 12-month follow-up in patients with solid or predominantly solid BNTN.DESIGN: Single-center, 12-month, randomized, superiority, open-label, parallel-group trial.SETTING: Outpatient clinic.PATIENTS AND INTERVENTIONS: Sixty patients with a solitary BNTN or dominant nodule characterized by pressure symptoms/cosmetic problems were randomly assigned (1:1 ratio) to receive either a single session of RFA or LA. 29 patients per group completed the study.MAIN OUTCOME MEASURE: s: VRR and proportion of nodules with more than 50% reduction (technical success rate).RESULTS: At 12 months, VRR was 70.9±16.9% and 60.0±19.0% in the RFA and LA groups, respectively (p=0.024). This effect was confirmed in the linear regression model that was adjusted for age, sex, nodule baseline volume and proportion of cellular components (RFA treatment: beta=0.390; p=0.009). No significant between-group difference was observed in the technical success rate at 12 months post-treatment. A statistically significant improvement was observed from the baseline to the 12-month follow-up for compression (RFA: 4.6 ± 2.6 and 1.3±0.8, p<0.001 and LA: 4.6 ± 2.1 and 1.6±0.8, respectively, p<0.001) and cosmetic (RFA: 3.4±0.6 and 1.3±0.5, p<0.001 and LA: 3.4±0.5 and 1.4±0.6, p<0.001) scores although the between-group differences were not significant.CONCLUSION: RFA achieved a significantly larger nodule volume reduction at 12 months; however, the technical success rate was similar in the RFA and LA groups.