Short-term outcomes and recurrent hyperthyroidism after radiofrequency ablation for solitary toxic thyroid nodules: A multicenter study.

Authors

Suedeh Ranjbar, Kelsy N Larios, Diane D Park, Elena G Hughes, Terrance Peng, Michael L Douek, Rizwan M Zafer, Michael W Yeh, Masha J Livhits, Mayumi Endo, Tracy S Tylee, James X Wu

Published in

Surgery. Pages 110593. Sep 01, 2026. Epub Sep 01, 2026.

Abstract

Radiofrequency ablation is an emerging minimally invasive therapy for toxic thyroid nodules. However, durability and optimal periprocedural management strategies remain incompletely characterized. This study aimed to evaluate short-term clinical outcomes following radiofrequency ablation for toxic thyroid nodules.
We conducted a multicenter retrospective study of adults who underwent radiofrequency ablation for toxic thyroid nodules between 2017 and 2025. Patients without postprocedural thyroid-stimulating hormone measurements were excluded. The primary outcome was durable biochemical response, defined as normalization of thyroid-stimulating hormone without antithyroid drugs. Secondary outcomes included emergency department visits for thyrotoxicosis, and associations between periprocedural antithyroid drug management strategies and biochemical outcomes were evaluated.
The cohort included 43 patients and was predominantly female (81.4%), with a median age of 49 years (interquartile range, 43-58). Prior to radiofrequency ablation, 44.2% were treated with methimazole. After a median follow-up of 6 months, 79.1% (34/43) achieved a durable biochemical response. Recurrent hyperthyroidism occurred in 20.9% (9/43) of patients, most often after an initial period of biochemical normalization. Median baseline-treated nodule volume tended to be larger among patients with recurrent hyperthyroidism compared with those with durable response (14.7 mL [interquartile range, 10.5-30.7] versus 6.8 mL [interquartile range, 2.9-13.9]). Median percent volume reduction exceeded 65% in both groups and was not associated with biochemical outcome. No patients required emergency department evaluation or hospitalization for thyrotoxicosis.
Radiofrequency ablation achieved durable biochemical response in approximately 80% of patients with toxic thyroid nodules. Recurrent hyperthyroidism after initial improvement highlights the need for long-term biochemical surveillance.

PMID:
43020693
Bibliographic data and abstract were imported from PubMed on 13 Nov 2026.

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