Background Radiofrequency ablation (RFA) has emerged as a minimally invasive and effective alternative to surgery for benign thyroid nodules, providing significant volume reduction and symptom relief. However, approximately one in five patients experience regrowth requiring retreatment. This study aimed to identify robust predictive factors—spanning the pre-, peri-, and post-treatment periods—to guide patient selection and follow-up strategies. Methods In this retrospective cohort study, 293 patients underwent RFA for benign thyroid nodules at Pitié-Salpêtrière Hospital between 2018 and 2023. Retreatment, defined as a second RFA within five years, was the primary outcome. Twelve clinical and treatment variables were analyzed using univariate and multivariate logistic regression. Predictive performance was assessed with receiver operating characteristic (ROC) curves and corresponding area under the curve (AUC) values. Results Sixty-one patients (20.8%) required retreatment. Amongst twelve parameters from three periods (pre-treatment, per-treatment and post-treatment), optimal multivariate models identified six significant ones. The pre-treatment growth rate (AUC = 0.808, OR = 1.505; 95% CI: 1.182–1.952, p- value 70% when viable volume exceeded 18.05 mL. Four predictive abacuses were developed to facilitate clinical application. Conclusion Pre-treatment growth rate and six-month viable volume are strong, independent predictors of retreatment after RFA of benign thyroid nodules. Incorporating these parameters into clinical decision-making may enhance patient selection, tailor treatment intensity, and inform follow-up intervals, thereby reducing the risk of retreatment and improving cost-effectiveness.
Hamou et al. (Mon,) studied this question.