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Comparing hemithyroidectomy and total thyroidectomy for low-risk thyroid cancers

Hemithyroidectomy or Total-Thyroidectomy in 'Low-risk' Thyroid Cancers

Not applicable Interventional University College, London · NCT05604963

This study is testing whether a less extensive thyroid surgery is just as effective as a full thyroid removal for people with low-risk thyroid cancer.

Quick facts

PhaseNot applicable
Study typeInterventional
Enrollment456 (estimated)
Ages16 Years and up
SexAll
SponsorUniversity College, London Academic / other
Locations33 sites (Crewe, Cheshire and 32 other locations)
Trial IDNCT05604963 on ClinicalTrials.gov

What this trial studies

This clinical trial is a multi-centre, randomised, non-inferiority study aimed at evaluating the effectiveness of hemithyroidectomy versus total thyroidectomy in patients with low-risk differentiated thyroid cancer. Patients will be divided into two groups: those who have previously undergone hemithyroidectomy and are diagnosed with low-risk cancer, and those diagnosed without prior surgery. Each group will be randomized to receive either surveillance or surgery, allowing researchers to assess the cost-effectiveness and outcomes of the two surgical approaches. The study aims to enroll a total of 456 patients to provide robust data on the best surgical option.

Who should consider this trial

Good fit: Ideal candidates for this study are patients aged 16 or over diagnosed with low-risk differentiated thyroid cancer.

Not a fit: Patients with high-risk thyroid cancer or those who have not undergone prior hemithyroidectomy may not benefit from this study.

Why it matters

Potential benefit: If successful, this study could provide a less invasive surgical option for patients with low-risk thyroid cancer, potentially reducing complications and healthcare costs.

How similar studies have performed: Other studies have explored surgical options for thyroid cancer, but this specific comparison of hemithyroidectomy versus total thyroidectomy in low-risk cases is relatively novel.

Eligibility criteria

Show full inclusion / exclusion criteria 
Group 1 (HT already performed prior to diagnosis)

Inclusion criteria

• Aged 16 or over

Papillary thyroid cancer:

* pT1b-2 (≤4cm) irrespective of molecular genetic markers
* R0 resection (clinically excised but microscopic R1 resected tumours at discretion of the local MDT)
* cN0 or pN0, pNX \& pN1a (≤5 foci, no extranodal spread)
* Confined to thyroid or minimal extrathyroidal extension
* No higher risk histological variants on morphology (small foci allowed at the discretion of the local MDT)
* No angioinvasion NB. PTC is still eligible where microscopic invasion of endothelial lined small capillary vascular spaces and lymphatic channels are present. It becomes ineligible in the rare instances when there is definite invasion of a larger vascular structure such as a vein with smooth muscle in its wall.
* Encapsulated FVPTC with capsular invasion only
* Micro-PTC (≤1cm)

  * multifocal
  * unifocal with pN1a (≤5 foci; no extranodal spread)

Follicular thyroid cancer (FTC), including oncocytic or Hürthle cell carcinoma:

* pT1b-2 (≤4cm) irrespective of molecular genetic markers

  \- Minimally invasive, with capsular invasion +/- minimal (≤4 foci) vascular invasion (the latter is now called encapsulated angioinvasive and is at the discretion of the MDT)
* Confined to thyroid or minimal extrathyroidal extension

Exclusion criteria

* \>4cm
* unifocal pT1a (≤1cm) PTC or FTC (unless pN1a as above)
* NIFTP (non-invasive follicular thyroid neoplasm with papillary-like nuclear features)
* Anaplastic, poorly differentiated or medullary thyroid carcinoma
* R2
* gross extrathyroidal extension
* pT4 or macroscopic tumour invasion of loco-regional tissues or structures
* pN1a with \>5 foci or extranodal spread
* pN1b
* M1
* Aggressive PTC with any of the following features:

  * Widely invasive
  * Poorly differentiated
  * Anaplastic
  * predominance of Tall cell, Columnar cell, Hobnail, Diffuse sclerosing and other higher risk variants
* FTC, including oncocytic or Hürthle cell cancer with any of the following features:

  * Minimally invasive with extensive vascular invasion (now called encapsulated angioinvasive) (\>4 foci)
  * Widely invasive
  * Poorly differentiated
  * Anaplastic

Group 2 (DTC on cytology or after core biopsy, who has not had prior thyroid surgery yet)

Inclusion criteria

* Aged 16 or over
* 'low risk' differentiated thyroid cancer confirmed by cytology or core biopsy.
* cT1b-2 irrespective of molecular genetic markers
* cN0
* Contralateral lobe without suspicious nodule(s) (U2, or U3/U4 with Thy2 on FNAC)

Exclusion criteria

• M1

Where this trial is running

Crewe, Cheshire and 32 other locations

Study contacts

How to participate

  1. Review the eligibility criteria above with your treating physician.
  2. Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
  3. Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.
View on ClinicalTrials.gov → Find more trials like this →
Conditions Differentiated Thyroid Cancer
Last reviewed 2026-06-09 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.