BAETS continues to support other ongoing projects as part of the association. Current projects include:
Radiofrequency ABlation of Benign Intrathyroidal Tumours (RABBIT Trial)
Aim: A randomised comparator trial proposal in a collaboration between surgeons, radiologists, endocrinologists, patient groups and professional bodies from across the UK in response to an NIHR commissioned call to examine radiofrequency ablation (RFA) vs open surgery for benign symptomatic thyroid nodules. Training will be provided for centres that are not currently carrying out RFA
If you would be interested in participating in the trial and would like more information please contact Neil Sharma (n.sharma@bham.ac.uk)
Completion thyroidectomy with or without central neck dissection for incidental N1a thyroid cancer found at hemithyroidectomy – CoNCent Study
Aim: This study aims to determine whether completion thyroidectomy with central neck dissection and radioiodine confer an advantage over completion thyroidectomy and radioiodine, for patients with papillary thyroid cancer, clinically and radiologically N0, but pathologically N1a due to incidental positive node(s) identified at hemithyroidectomy? Outcomes will primarily include quality of life metrics, but also examine clinical cancer outcomes as well. Through access to PHE and HES data, as well as access to UKRETS, ongoing pilot work is examining the scope of the issue as well as clinical and patient importance, with an RFPB grant application planned for later this year.
If you would like further information or would like to be involved, please contact Neil Sharma (n.sharma@bham.ac.uk)
The UK PARACAN study – diagnosis and management of parathyroid cancer – a multicentre service evaluation
Aim: Parathyroid cancer is rare malignancy with an incidence of 0.5 per million per year. It almost always occurs in the context of primary or secondary hyperparathyroidism. The diagnosis is difficult to make prior to surgical treatment; given the rarity of malignancy in patients with hyperparathyroidism and the lack of accurate biomarkers or imaging features. Difficulty in diagnosis often results in either inadequate initial surgery (in patients with cancer) or unnecessary radical procedures (in those with benign disease). Pathological diagnosis is also difficult as there is an overlap of histological features in benign and malignant disease. There are not standard protocols for management or follow-up of these patients after initial surgical treatment
A service evaluation project aims to evaluate the diagnostic and management strategies of patients with parathyroid cancer in the UK. The plan is to capture all cases of atypical adenoma and parathyroid cancer in the participating centres over a five-year period and collect relevant clinical, biochemical, histology and treatment details. The results of this study will enable us to understand the epidemiology of this rare cancer, explore the variation in care and identify areas for improvement. It is expected that the results of this study will help in the formulation of research questions that will improve management and reduce variation in care of patients with parathyroid cancer
If you would like further information or would like to be involved please contact s.p.balasubramanian@sheffield.ac.uk
Thy3000 – a national observational study of the epidemiology and initial management pathway of thyroid nodules
Aim: Thyroid nodules are common and in some instances are associated with malignancy and/or thyroid dysfunction. Thyroid cancer is often slow growing or dormant and usually associated with a good or excellent prognosis. Thyroid cancer has been increasing in incidence over the last few decades, at least partly due to the increase in incidental identification and investigation of thyroid nodules. There is ongoing concern about the extent of over diagnosis of thyroid cancer and the morbidity associated with over treatment of both benign and malignant thyroid nodules. There is also concern about variation in methods of assessment and management of patients with thyroid nodules across the U.K.
This multi-centre retrospective cohort observational study aims to determine the demographics, mode of presentation, diagnostic and management strategies and the distribution of pathology in a consecutive series of patients presenting with thyroid nodules over a six-month period at several secondary care trusts in the U.K.
The results of this study will increase the understanding of the epidemiology of thyroid nodules and the nature of practice across the U.K.
If you would like further information or would like to be involved, please contact s.p.balasubramanian@sheffield.ac.uk
(ovieedafe@hotmail.co.uk) (s.p.balasubramanian@sheffield.ac.uk
The NIFTy trial – near infrared fluorescent imaging in thyroid surgery – a process evaluation followed by a phase 2/3, multicentre, randomised controlled trial of near infrared fluorescent imaging in reducing post-surgical hypoparathyroidism after thyroid surgery
Aim: Post-surgical hypoparathyroidism (PoSH) is a significant complication of thyroid surgery and several intraoperative technologies are being explored to reduce the risk of this complication. Fluorescent imaging (with and without the use of exogenous dyes) have shown promise in early studies. The aim of the study is to determine the efficacy of near infra-red fluorescence (NIRF) imaging (with Indocyanine Green) in reducing the risk of post-surgical hypoparathyroidism after bilateral thyroid surgery in a multi-centre randomised controlled trial comparing NIRF imaging versus standard surgery
Currently, the process evaluation part of the study is underway in a single centre. Thyroid surgeons in the UK are being invited to participate in a survey, whose results will be used to develop a guide for the use of NIRF in thyroid surgery. This technology will then be evaluated in the multi-centre randomised trial in the U.K.
If you would like further information or would like to be involved, please contact s.p.balasubramanian@sheffield.ac.uk