Objective. This study aimed to investigate potentially favorable factors influencing the therapeutic success of radiofrequency ablation (RFA) of huge benign thyroid nodules (BTNs) (volume >100 ml) and to evaluate the feasibility of RFA as an alternative treatment modality for patients unable or unwilling to undergo surgery. Methods. This retrospective study evaluated a total of 868 patients, of which 22 patients had huge BTNs who underwent ultrasound-guided moving shot RFA treatment between May 2017 and January 2022. The huge BTNs were categorized into two groups according to a post-RFA treatment volume reduction ratio (VRR) of >80% and <80% at 6 months. Factors influencing these huge BTNs were reviewed, analyzed, and correlated with treatment effectiveness between the two groups. Results. The factors influencing an effective VRR included huge BTNs located on the left side (OR 7.875, p = 0.03), predominant solid/spongiform nodules (OR 7.875, p = 0.03), and higher initial ablation rate (IAR) (p = 0.028). Multivariable logistic regression revealed predominant solid/spongiform nodule and the higher IAR were associated with the advanced VRR. Conclusion. RFA was effective at decreasing the volume of huge BTNs with an acceptable complication rate. The BTN characteristics correlated with a better VRR at the 6-month short-term follow-up were predominant solid/spongiform BTNs and those with the first time ablation treatment initial ablation rate. Nevertheless, regarding the higher regrowth rate of these groups of patients who may need to be treated more times, RFA can only be a feasible alternative treatment modality for patients unable or unwilling to undergo operation.

中文翻译：

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影响巨大良性甲状腺结节 RFA 良好结果的因素：初步结果和短期评估

客观的。本研究旨在调查影响巨大良性甲状腺结节 (BTN)（体积 >100 ml）射频消融 (RFA) 治疗成功的潜在有利因素，并评估 RFA 作为无法或不愿意的患者的替代治疗方式的可行性进行手术。方法。这项回顾性研究共评估了 868 名患者，其中 22 名患有巨大 BTN 的患者在 2017 年 5 月至 2022 年 1 月期间接受了超声引导移动射击 RFA 治疗。根据 RFA 治疗后体积减少情况，将巨大 BTN 分为两组6 个月时比率 (VRR) >80% 且 <80%。我们对影响这些巨大 BTN 的因素进行了审查、分析，并将其与两组之间的治疗效果相关联。结果。影响有效 VRR 的因素包括位于左侧的巨大 BTN（OR 7.875，p  = 0.03）、主要的实性/海绵状结节（OR 7.875，p  = 0.03）和较高的初始消融率（IAR）（p  = 0.028） 。多变量逻辑回归显示主要为实性/海绵状结节，较高的 IAR 与晚期 VRR 相关。结论。RFA 可有效减少巨大 BTN 的体积，并且并发症发生率可接受。在 6 个月的短期随访中，与更好的 VRR 相关的 BTN 特征主要是固体/海绵状 BTN 和首次消融治疗初始消融率的 BTN。然而，考虑到这些患者的再生长率较高，可能需要更多次的治疗，对于无法或不愿接受手术的患者来说，RFA只能是一种可行的替代治疗方式。