Success of Microwave Ablation Treatment for Thyroid Nodules in Older Adults

Background Evaluation of the efficacy of Microwave ablation (MWA) in the treatment of symptomatic benign thyroid nodules in older adults. Methods The study included 21 older and 65 adult patients. Clinical, radiologic and biochemical follow-up of the nodules was performed before and 3 and 6 months after the MWA procedure. Results Initial nodule volume and volume at 1st control in the older and adult groups, respectively:11.8 [5.7–28.3] mL; 6.2 [2.5–16.2] mL, p < .001 and 11.2 [6.1–21.2] mL; 5.4 [3.07 + 9.5] mL, p < .001. When comparing the nodule volume between the 1st and 2nd control (older patients 4.3 [1.3–11.4] mL; adult patients 3.4 [1.6–6.1] mL), a significant reduction was observed ( p < .001 , p < .001 ). The nodule volume shrinkage rate during the 6-month follow-up period was 64 ± 15% in the older patients and 66 (55–74) %) in the adult group ( p  = 0.74). The shrinkage rate of solid, cystic and mixed thyroid nodules with MWA treatment was similar among the three nodules, p  = 0.33, p  = 0.37 in the older and adult groups, respectively. A weak correlation was found between the age-adjusted Charlson Comorbidity Index (aCCI) score and the rate of nodule shrinkage ( p  = 0.05, r=-0.219). No complications were observed in the older group. In adults, 2 patients experienced transient hoarseness. Conclusions When planning the treatment of thyroid nodules in older adults due to multimorbidity, the risks and benefits must be weighed taking into account the increased risk of complications. In our study, the results of MWA treatment in the older population were successful and reliable in terms of complications. Clinical significance: MWA is a safe and effective treatment for benign thyroid nodules in older patients.