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Thyroid CancerGDNCT07059507

Prevalence and Predictors of Incidental Thyroid Carcinoma in Patients With Graves' Disease Undergoing Thyroidectomy.

An observational study of Thyroid Cancer and Graves Disease, run by Minia University at 1 site in Egypt.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The prevalence of incidental thyroid cancer (ITC) in Graves' Disease (GD) patients undergoing thyroidectomy appears higher than historically believed, potentially exceeding 10% in large contemporary series, although significant variability exists. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Thyroid Cancer, Graves Disease
What is being tested?
Total thyroidectomy
Type of treatment
Surgery or procedure
How many people
280 participants
Where
1 siteEgypt
Study dates
15 Jul 2025to 15 Jan 2027
How long will I take part?
1 Month
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Adult patients diagnosed with Graves' disease undergoing total thyroidectomy at Minia University Hospital, a tertiary care center with specialized endocrine surgery services.

Who may be able to join

  • Age 18 years or older.
  • Confirmed diagnosis of Graves' disease based on clinical features (e.g., diffuse goiter, ophthalmopathy if present) and biochemical evidence (suppressed TSH, elevated free T4 and/or T3) and/or positive TSH receptor antibody (TRAb) test.
  • Indication for total thyroidectomy for Graves' disease, based on established guidelines:
  • Relapse or persistence of hyperthyroidism after a course of antithyroid drugs (ATDs).
  • Intolerance or adverse reaction to ATDs. Patient preference for surgery over radioactive iodine (RAI) or long-term ATDs. Presence of a large goiter causing compressive symptoms. Coexisting suspicious thyroid nodule(s) on preoperative evaluation. Moderate to severe active Graves' ophthalmopathy where RAI is relatively contraindicated.
  • Patient is scheduled for total thyroidectomy (near-total or subtotal thyroidectomy patients will be excluded).
  • Ability and willingness to provide written informed consent.
  • Ability to understand study procedures and requirements.

Who cannot join

  • Age less than 18 years.
  • Previous thyroid surgery.
  • Previous neck irradiation.
  • Preoperative diagnosis of thyroid malignancy confirmed by fine-needle aspiration (FNA) cytology (Bethesda V or VI) , the focus is on incidental carcinoma.
  • Inability to provide informed consent (e.g., due to cognitive impairment).
  • Patients undergoing thyroidectomy primarily for reasons other than Graves' disease (e.g., primary indication is large non-toxic MNG).
  • Patients undergoing less than total thyroidectomy (e.g., lobectomy, subtotal thyroidectomy).

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Egypt1 site, 1 recruiting
  • Minia University Hospital

    Minya, Minya Governorate, 61519

    Saleh K Saleh, 01201765401 ext. +2, salehkhairy@mu.edu.eg

    Rabeh K Saleh, MD

    Recruiting

Other trials in Egypt

About this study

Official title: Prevalence and Predictors of Incidental Thyroid Carcinoma in Patients With Graves' Disease Undergoing Thyroidectomy: A Prospective Study.

The prevalence of incidental thyroid cancer (ITC) in Graves' Disease (GD) patients undergoing thyroidectomy appears higher than historically believed, potentially exceeding 10% in large contemporary series, although significant variability exists. The presence of nodules is a strong predictor, while the roles of age, sex, and BMI require clarification. Most ITCs are papillary thyroid microcarcinoma(PTMCs) with generally favorable prognoses, but concerns about aggressiveness persist.

The purpose of the present study is to accurately evaluate the prevalence of incidental thyroid carcinoma (ITC), including microcarcinomas, in a prospectively enrolled cohort of patients undergoing total thyroidectomy for Graves' disease, utilizing standardized pathological examination protocols and secondary outcomes including predictors and histopathological characteristics.

Read the detailed description

Graves' disease (GD) is the most common cause of hyperthyroidism, affecting approximately 0.5% of the US population.

While definitive treatment often involves radioactive iodine (RAI) or antithyroid drugs (ATDs), thyroidectomy is increasingly utilized, especially for patients with large goiters, compressive symptoms, coexisting suspicious nodules, or contraindications/failure of other therapies.

However, numerous studies over the past few decades have challenged this notion, reporting varying rates of incidental thyroid carcinoma (ITC) discovered in thyroidectomy specimens from GD patients. Understanding the true prevalence and identifying predictors of incidental thyroid cancer (ITC) in this population is crucial for appropriate patient counseling, surgical decision-making, and determining the optimal extent of thyroidectomy.

Identifying factors associated with an increased risk of incidental thyroid cancer in GD patients could help stratify risk and guide management. Several potential predictors in literatures reviews have been investigated, with some conflicting results:

  • Presence of Nodules: The presence of thyroid nodules within the diffuse goiter of GD is a consistently reported risk factor for ITC.
  • Age: Some studies suggest older age is a risk factor. However others, identified younger age as a predictor. This discrepancy requires further investigation.
  • Sex: Male sex has been identified as a risk factor in some studies, although GD is much more prevalent in females.
  • Body Mass Index (BMI): patients with cancer had a higher BMI.
  • Thyroid Autoantibodies and Thyroglobulin: thyroid peroxidase antibodies (TPOAbs), thyroglobulin antibody(TgAbs), and thyroglobulin(Tg) levels but found no statistically significant differences between benign and malignant groups in their cohort undergoing total thyroidectomy for benign diseases. The role of specific GD-related antibodies (e.g., thyroid-stimulating hormone (TSH) receptor antibodies) as predictors requires further study.

The study will enroll approximately 280 patients , utilizing standardized data collection (demographics, clinical history, laboratory, imaging and operative data) and pathological examination protocols. The primary outcome is the prevalence of incidental thyroid cancer (ITC), secondary outcomes including predictors and histopathological characteristics.

Being tested
Total thyroidectomy
Keywords
Incidental thyroid cancer
Medical subject headings
Thyroid Neoplasms, Graves Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Total thyroidectomyProcedure or surgery

    Remove of both thyroid lobes and isthmus

Study groups in NCT07059507
Study groupRoleWhat they receive
Graves' Disease Undergoing ThyroidectomyRemove of both thyroid lobes and isthmus
Receives: Procedure: Total thyroidectomy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Prevalence of Incidental Thyroid Carcinoma (ITC)

    The proportion of patients with histologically confirmed incidental thyroid carcinoma, including microcarcinomas, among those undergoing total thyroidectomy for Graves' disease.

    Measured: Assessed at the time of final pathology report post-surgery (within 30 days post-operation).Histopathological examination of thyroidectomy specimens using standardized protocols.

Secondary outcomes (2)
  1. Factors Associated with Incidental Thyroid Carcinoma (ITC) Risk.

    Identification of predictors for incidental thyroid carcinoma (ITC) through univariate and multivariate logistic regression analysis of preoperative clinical, laboratory, imaging, and demographic data. Factors to be assessed include, but are not limited to, presence of nodules, age, sex, and Body Mass Index (BMI).

    Measured: Assessed at the time of data analysis, approximately 1 year after enrollment completion.

  2. Histopathological Characteristics of Incidental Thyroid Carcinoma.

    Frequency and percentage of ITC characteristics (e.g., histological type, size, stage, multifocality).

    Measured: Assessed at the time of final pathology report post-surgery (within 30 days post-operation).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted10 Jul 2025
  2. Study start15 Jul 2025
  3. Primary completion15 Dec 2026 (estimated)
  4. Study completion15 Jan 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Prospective
Enrolment
280 participants (estimated)
Target duration
1 Month
IDs, dates and publications
ClinicalTrials.gov ID
NCT07059507
Sponsor's protocol ID
1574/06/2025
Acronym
GD
Status last verified
Aug 2026
First submitted
1 Jul 2025
Last updated
11 Aug 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Moronta S, Slattery L, Wang R, Nwariaku F, McMullin JL. Incidental Thyroid Cancer in Patients With Graves' Disease: Not as Rare as We Previously Believed. J Surg Res. 2025 Apr;308:122-128. doi: 10.1016/j.jss.2025.02.024. Epub 2025 Mar 17.

    PubMed 40101333
  • Ross DS, Burch HB, Cooper DS, Greenlee MC, Laurberg P, Maia AL, Rivkees SA, Samuels M, Sosa JA, Stan MN, Walter MA. 2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis. Thyroid. 2016 Oct;26(10):1343-1421. doi: 10.1089/thy.2016.0229.

    PubMed 27521067
  • Patel KN, Yip L, Lubitz CC, Grubbs EG, Miller BS, Shen W, Angelos P, Chen H, Doherty GM, Fahey TJ 3rd, Kebebew E, Livolsi VA, Perrier ND, Sipos JA, Sosa JA, Steward D, Tufano RP, McHenry CR, Carty SE. The American Association of Endocrine Surgeons Guidelines for the Definitive Surgical Management of Thyroid Disease in Adults. Ann Surg. 2020 Mar;271(3):e21-e93. doi: 10.1097/SLA.0000000000003580.

    PubMed 32079830
  • Staniforth JUL, Erdirimanne S, Eslick GD. Thyroid carcinoma in Graves' disease: A meta-analysis. Int J Surg. 2016 Mar;27:118-125. doi: 10.1016/j.ijsu.2015.11.027. Epub 2015 Nov 26.

    PubMed 26626367
  • Phitayakorn R, McHenry CR. Incidental thyroid carcinoma in patients with Graves' disease. Am J Surg. 2008 Mar;195(3):292-7; discussion 297. doi: 10.1016/j.amjsurg.2007.12.006.

    PubMed 18206132
  • You E, Mascarella MA, Al Jassim A, Forest VI, Hier MP, Tamilia M, Pusztaszeri M, Payne RJ. Prevalence and aggressiveness of papillary thyroid carcinoma in surgically-treated graves' disease patients: a retrospective matched cohort study. J Otolaryngol Head Neck Surg. 2019 Aug 28;48(1):40. doi: 10.1186/s40463-019-0364-5.

    PubMed 31462328
  • Askitis D, Efremidou EI, Karanikas M, Mitrakas A, Tripsianis G, Polychronidis A, Liratzopoulos N. Incidental thyroid carcinoma diagnosed after total thyroidectomy for benign thyroid diseases: incidence and association with thyroid disease type and laboratory markers. Int J Endocrinol. 2013;2013:451959. doi: 10.1155/2013/451959. Epub 2013 Nov 20.

    PubMed 24348554
  • Hay ID, Hutchinson ME, Gonzalez-Losada T, McIver B, Reinalda ME, Grant CS, Thompson GB, Sebo TJ, Goellner JR. Papillary thyroid microcarcinoma: a study of 900 cases observed in a 60-year period. Surgery. 2008 Dec;144(6):980-7; discussion 987-8. doi: 10.1016/j.surg.2008.08.035.

    PubMed 19041007

Questions about this trial

What is this clinical trial studying?

An observational study of Thyroid Cancer and Graves Disease, run by Minia University at 1 site in Egypt.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 8 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 11 Aug 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Saleh K Saleh, MD (01201765401 ext. +2, salehkhairy@mu.edu.eg), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Prevalence of Incidental Thyroid Carcinoma (ITC) (time frame: Assessed at the time of final pathology report post-surgery (within 30 days post-operation).Histopathological examination of thyroidectomy specimens using standardized protocols.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07059507, which also lists 8 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Aug 2026.

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