Ethanol ablation of thyroid cysts in the young with a focus on efficacy and quality of life
Language English Country Great Britain, England Media electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
37432713
PubMed Central
PMC10448585
DOI
10.1530/etj-23-0085
PII: e230085
Knihovny.cz E-resources
- Keywords
- ethanol ablation (EA), quality of life (QoL), thyroid cyst, ultrasound-guided percutaneous ethanol injection therapy (US-PEIT), volume reduction ratio,
- MeSH
- Cysts * diagnosis MeSH
- Adult MeSH
- Ethanol therapeutic use MeSH
- Quality of Life MeSH
- Humans MeSH
- Young Adult MeSH
- Thyroid Neoplasms * MeSH
- Adenoma, Oxyphilic * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Ethanol MeSH
OBJECTIVE: Ultrasound-guided percutaneous ethanol injection therapy (US-PEIT) is used in patients with recurrent symptomatic thyroid cysts as a credible alternative to surgery. Young patients commonly do not wish to undergo surgery and prefer ethanol ablation, if available. The effect of this approach on quality of life is an essential factor in deciding on the treatment options, especially in the young with a long life expectancy and no comorbidity. METHODS: We performed US-PEIT in a cohort of young patients, 15-30 years, from 2015 to 2020. The patients' general quality of life (QoL), self-reported compression symptoms and neck appearance were evaluated. RESULTS: The cohort comprised 59 patients with 63 cysts, more women than men, with a mean age of 23.8 years. About 1.5 mL of injected alcohol were needed to reach a 90.7% mean cyst volume reduction ratio in 12 months. The method did not fail in any of the patients; a single US-PEIT session was undertaken in 46% of them. The procedure significantly improved each of the patients' symptoms with a significant total score difference (P < 0.001). The total symptom score correlated with the initial cyst volume (P = 0.002; r = 0.395). The mean QoL score by SF-36 6 months after the last US-PEIT was significantly different for physical component summary 56.5 (P < 0.001) but not different for mental component summary 47.7 (P = 0.125), compared to age-corresponding norms. CONCLUSIONS: US-PEIT is a safe and effective method for the young, leading to improvements in cosmetic and subjective complaints, and should also be considered as first-line treatment in the young.
See more in PubMed
Welker MJ & Orlov D. Thyroid nodules. American Family Physician 200367559–566. PubMed
McHenry CR Slusarczyk SJ & Khiyami A. Recommendations for management of cystic thyroid disease. Surgery 19991261167–1172. (10.1067/msy.2099.101423) PubMed DOI
Moon WJ, Baek JH, Jung SL, Kim DW, Kim EK, Kim JY, Kwak JY, Lee JH, Lee JH, Lee YH, et al.Ultrasonography and the ultrasound-based management of thyroid nodules: consensus statement and recommendations. Korean Journal of Radiology 2011121–14. (10.3348/kjr.2011.12.1.1) PubMed DOI PMC
Bennedbaek FN & Hegedus L. Treatment of recurrent thyroid cysts with ethanol: a randomized double-blind controlled trial. Journal of Clinical Endocrinology and Metabolism 2003885773–5777. (10.1210/jc.2003-031000) PubMed DOI
Haugen BR, Alexander EK, Bible KC, Doherty GM, Mandel SJ, Nikiforov YE, Pacini F, Randolph GW, Sawka AM, Schlumberger M, et al.2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer: the American Thyroid Association guidelines task force on thyroid nodules and differentiated thyroid cancer. Thyroid 2016261–133. (10.1089/thy.2015.0020) PubMed DOI PMC
Durante C Grani G Lamartina L Filetti S Mandel SJ & Cooper DS. The diagnosis and management of thyroid nodules: a review. JAMA 2018319914–924. (10.1001/jama.2018.0898) PubMed DOI
Yasuda K Ozaki O Sugino K Yamashita T Toshima K Ito K & Harada T. Treatment of cystic lesions of the thyroid by ethanol instillation. World Journal of Surgery 199216958–961. (10.1007/BF02067001) PubMed DOI
Zingrillo M Torlontano M Ghiggi MR D’Aloiso L Nirchio V Bisceglia M & Liuzzi A. Percutaneous ethanol injection of large thyroid cystic nodules. Thyroid 19966403–408. (10.1089/thy.1996.6.403) PubMed DOI
Gharib H, Papini E, Paschke R, Duick DS, Valcavi R, Hegedus L, Vitti P. & AACE/AME/ETA Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, associazione Medici Endocrinologi, and Europeanthyroid Association medical guidelines for clinical practice for the diagnosis and management of thyroid nodules. Endocrine Practice 201016(Supplement 1) 1–43. (10.4158/10024.GL) PubMed DOI
Gharib H, Papini E, Garber JR, Duick DS, Harrell RM, Hegedus L, Paschke R, Valcavi R, Vitti P. & AACE/ACE/AME Task Force on Thyroid Nodules. American Association of Clinical Endocrinologists, American college of endocrinology, and associazione medici endocrinologi medical guidelines for clinical practice for the diagnosis and management of thyroid nodules--2016 update. Endocrine Practice 201622622–639. (10.4158/EP161208.GL) PubMed DOI
Hahn SY, Shin JH, Na DG, Ha EJ, Ahn HS, Lim HK, Lee JH, Park JS, Kim JH, Sung JY, et al.Ethanol ablation of the thyroid nodules: 2018 consensus statement by the Korean society of thyroid radiology. Korean Journal of Radiology 201920609–620. (10.3348/kjr.2018.0696) PubMed DOI PMC
Del Prete S, Caraglia M, Russo D, Vitale G, Giuberti G, Marra M, D’Alessandro AM, Lupoli G, Addeo R, Facchini G, et al.Percutaneous ethanol injection efficacy in the treatment of large symptomatic thyroid cystic nodules: ten-year follow-up of a large series. Thyroid 200212815–821. (10.1089/105072502760339398) PubMed DOI
Halenka M Karasek D Schovanek J & Frysak Z. Safe and effective percutaneous ethanol injection therapy of 200 thyroid cysts. Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia 2020164161–167. (10.5507/bp.2019.007) PubMed DOI
Cho YS Lee HK Ahn IM Lim SM Kim DH Choi CG & Suh DC. Sonographically guided ethanol sclerotherapy for benign thyroid cysts: results in 22 patients. AJR. American Journal of Roentgenology 2000174213–216. (10.2214/ajr.174.1.1740213) PubMed DOI
Sung JY Baek JH Kim YS Jeong HJ Kwak MS Lee D & Moon WJ. One-step ethanol ablation of viscous cystic thyroid nodules. AJR. American Journal of Roentgenology 20081911730–1733. (10.2214/AJR.08.1113) PubMed DOI
Kim DW Rho MH Kim HJ Kwon JS Sung YS & Lee SW. Percutaneous ethanol injection for benign cystic thyroid nodules: is aspiration of ethanol-mixed fluid advantageous? AJNR. American Journal of Neuroradiology 2005262122–2127. PubMed PMC
Reverter JL Alonso N Avila M Lucas A Mauricio D & Puig-Domingo M. Evaluation of efficacy, safety, pain perception and health-related quality of life of percutaneous ethanol injection as first-line treatment in symptomatic thyroid cysts. BMC Endocrine Disorders 20151573. (10.1186/s12902-015-0069-3) PubMed DOI PMC
Jeong SY Ha EJ Baek JH Kim TY Lee YM Lee JH & Lee J. Assessment of thyroid-specific quality of life in patients with benign symptomatic thyroid nodules treated with radiofrequency or ethanol ablation: a prospective multicenter study. Ultrasonography 202241204–211. (10.14366/usg.21003) PubMed DOI PMC
Ware JE, Sherbourne CD. & The MOS. The MOS 36-item short-form health survey (SF-36) I. Conceptual framework and item selection. Medical Care 199230473–483. (10.1097/00005650-199206000-00002) PubMed DOI
Sobotík Z. Zkušenosti s použitím předběžné české verze amerického dotazníku o zdraví (SF-36). Zdravotnictví v České republice 1998150–54.
Ware J Ma K & Keller SD. SF-36 physical and mental health summary scales: a User’s manual. Boston, MA: Health Assessment Lab, 199323–28.
Kim YJ Baek JH Ha EJ Lim HK Lee JH Sung JY Kim JK Kim TY Kim WB & Shong YK. Cystic versus predominantly cystic thyroid nodules: efficacy of ethanol ablation and analysis of related factors. European Radiology 2012221573–1578. (10.1007/s00330-012-2406-5) PubMed DOI
Raggiunti B Fiore G Mongia A Balducci G Ballone E & Capone F. A 7-year follow-up of patients with thyroid cysts and pseudocysts treated with percutaneous ethanol injection: volume change and cost analysis. Journal of Ultrasound 200912107–111. (10.1016/j.jus.2009.06.002) PubMed DOI PMC
Cho W Sim JS & Jung SL. Ultrasound-guided ethanol ablation for cystic thyroid nodules: effectiveness of small amounts of ethanol in a single session. Ultrasonography 202140417–427. (10.14366/usg.20170) PubMed DOI PMC
Barbus E Pestean C Larg MI & Piciu D. Quality of life in thyroid cancer patients: a literature review. Clujul Medical 201790147–153. (10.15386/cjmed-703) PubMed DOI PMC