Radiofrequency Ablation Versus Hemithyroidectomy of Small Thyroid Cancers

Official title

Multi-center, 1:1 Randomized, Stratified, Parallel-group, Non-inferiority Clinical Trial of Small Thyroid Cancers Treated with Hemithyroidectomy or Radiofrequency Ablation.

Overview

This is a multicenter randomized controlled trial including patients with small (\<2 cm) suspected or confirmed thyroid cancers. Patients are included after informed consent and randomized to one of two treatments. One treatment is a standard henithyroidectomy and the second treatment is radiofrequency ablation (RFA) of the specific tumor. The investigators will evaluate initial outcome of the allocated treatment, thyroid hormonal function, oncologic safety, quality of life, and treatment costs in a follow-up period of five years after treatment. The overall aim of the study is to improve patient's health by reducing the number of operations on small thyroid cancers. In patients with these small tumors, the long-term adverse outcome may be higher than possible benefits from the operation. For participants undergoing surgical treatment with HT, the investigators will measure final histology and both beneficial and adverse outcome from the operation. For participants undergoing RFA, the investigators expect to reduce the need for thyroid hormonal substitutions, reduce the surgical adverse outcomes, reduce treatment costs and increase QoL without a reduction in oncologic safety and outcome.

Interventions

• Procedure Radiofrequency ablation alone
  RFA of a cancer in the thyroid gland.
• Procedure Surgery
  Hemithyroidectomy of the thyroid lobe with cancer

Primary outcome measures

• Uncomplicated initial treatment (yes/no) [Time frame: One month after randomization.]

Secondary outcome measures (5)

• Oncologic [Time frame: 5 years after randomization.]
• Endocrinological 1 [Time frame: At three months, 1, 2, 3, 4 and 5 years after randomization.]
• Patient-reported outcome 1 [Time frame: At randomization (baseline), and at three months, 1, 2, 3, 4, and 5 years after randomization.]
• Health economics [Time frame: At 5 years after randomization.]
• Patient-reported outcome 2 [Time frame: At randomization (baseline), and at three months, 1, 2, 3, 4, and 5 years after randomization.]

Eligibility criteria

Inclusion criteria

• Single tumor in the thyroid gland with a FNAB suspecious of cancer or diagnostic of cancer (category V or VI in the Bethesda system)
• tumor size of less than 2 cm in all dimensions.

Exclusion criteria

• suspicion of disseminated disease because of PET-positive lymph nodes ; suspect lymph-nodes by ultrasonography (US); or signs of capsular invasion of the tumor OR
• tumor not eligible for RFA treatment because of high-risk location; previous thyroid surgery; concomitant hyperparathyroidism (ionized calcium > 1.32 mmol/L and PTH > 6 pmol//L ) OR
• if the patient is pregnant OR
• If the patient is unable to give informed consent.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Denmark · 1 center

• Department of Otorhinolaryngology, Aarhus University Hospital — Aarhus

Identifiers

NCT: NCT06796348 · RFARCT8200

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗