Hemi-or total Thyroidectomy (HoT) trial in low-risk thyroid cancer

Low-risk thyroid cancers have a very high cure rate with 99 out of every 100 patients surviving at least 10 years after diagnosis.

The current standard treatment for patients diagnosed with thyroid cancer is total removal of the thyroid gland (total thyroidectomy). A partial thyroid removal (hemithyroidectomy or lobectomy), which removes just the cancerous part of the thyroid gland, is also sometimes offered to patients with low-risk cancers. This procedure is less invasive and carries less risk of damage to the parathyroid glands. Patients are also less likely to have to take lifelong thyroid hormone replacement therapy.

The HoT trial is currently underway to investigate whether hemithyroidectomy is as effective as total thyroidectomy. The aim is to help patients and surgeons when deciding which type of surgery to have.

What does the HoT trial involve?

The trial is a randomised phase III trial, which will compare the outcomes of thyroid cancer patients treated with either total thyroidectomy or hemithyroidectomy. Patients who join the trial will be randomly allocated to receive either a total thyroidectomy or a hemithyroidectomy.

Where is the trial taking place?

The trial is being coordinated by Cancer Research UK and the University College London (UCL) Cancer Trials Centre. It plans to recruit 456 patients from 30 hospitals across the UK over four years.

Which patients are suitable for the trial?

Eligible patients will have a diagnosis of low-risk differentiated thyroid cancer and be aged 16 and above.

There will be two eligible groups of patients:

• Group 1: Patients who have already had a hemithyroidectomy for thyroid problems and are then subsequently diagnosed with low risk differentiated thyroid cancer. These patients will be randomised 1:1 to undergo surveillance (follow-up only) only OR a second operation to remove the rest of their thyroid gland (two-stage total thyroidectomy).
• Group 2: Patients diagnosed with low risk differentiated thyroid cancer using cytology (Thy5) or core biopsy but who haven’t yet had surgery. These patients will be randomised 1:1 to have either a hemi-thyroidectomy OR a single-stage total thyroidectomy.

How much monitoring will it involve?

Patients will be regularly monitored for a period of up to six and a half years.

How can I get involved in the trial? 

The trial has opened to recruitment at Lister Hospital, Ninewells Hospital, St George’s Hospital, Musgrove Park Hospital, Royal Marsden Hospitals, Sheffield Teaching Hospitals, NHS Lothian and Norfolk and Norwich Hospital. More trial sites will be opening soon.

Patients can only be recruited from hospitals that have opened for recruitment. Patients can contact the trial team on the link below for more information.

Why is the study randomised, rather than patients being able to choose which surgery they receive?

Allocating patients' treatment on a random basis means the data will have no bias in it. This will help the researchers to produce definitive evidence comparing the recurrence rate of both surgeries. It will also help the research to be noticed internationally.

More information about the trial  

Contact the trial team