Bladder Cancer Clinical Trial
Official title:
Transurethral En Bloc Versus Standard Resection of Bladder Tumour: A Multi-centre Randomised Controlled Trial (EB-StaR Study).
Verified date | June 2022 |
Source | Chinese University of Hong Kong |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Conventionally, transurethral standard resection (SR) of bladder tumour is performed in a piecemeal manner. Transurethral en bloc resection (EBR) has been described as an alternate surgical technique in bladder tumour resection. By preventing tumour fragmentation and ascertaining complete tumour resection by histological assessment of the EBR specimen, we hypothesized that EBR could reduce disease recurrence as compared to SR.
Status | Completed |
Enrollment | 350 |
Est. completion date | June 9, 2022 |
Est. primary completion date | February 11, 2022 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: - Age = 18 years old with informed consent Exclusion Criteria: - Bladder tumour base with maximal dimension of >3cm (Anticipated difficulty in retrieving the specimen en bloc) - Bladder tumour detected during intravesical BCG therapy (BCG failure warrants more aggressive treatment, i.e. radical cystectomy) - Histological diagnosis other than NMIBC - Presence or prior history of upper urinary tract malignancy - ECOG performance status = 3 (Confined to bed or chair more than 50% of waking hours) - ASA III or above (Patient with severe systemic disease) - History of bleeding disorder or use of anti-coagulants - Pregnancy - Presence of other active malignancy - Life expectancy of less than one year |
Country | Name | City | State |
---|---|---|---|
Hong Kong | Caritas Medical Centre | Hong Kong | |
Hong Kong | Kwong Wah Hospital | Hong Kong | |
Hong Kong | North District Hospital | Hong Kong | |
Hong Kong | Our Lady of Maryknoll Hospital | Hong Kong | |
Hong Kong | Pok Oi Hospital | Hong Kong | |
Hong Kong | Prince of Wales Hospital | Hong Kong | |
Hong Kong | Princess Margaret Hospital | Hong Kong | |
Hong Kong | Queen Elizabeth Hospital | Hong Kong | |
Hong Kong | Queen Mary Hospital | Hong Kong | |
Hong Kong | Tseung Kwan O Hospital | Hong Kong | |
Hong Kong | Tuen Mun Hospital | Hong Kong | |
Hong Kong | Tung Wah Hospital | Hong Kong | |
Hong Kong | United Christian Hospital | Hong Kong |
Lead Sponsor | Collaborator |
---|---|
Chinese University of Hong Kong | Caritas Medical Centre, Hong Kong, Kwong Wah Hospital, North District Hospital, Our Lady of Maryknoll Hospital, Pok Oi Hospital, Princess Margaret Hospital, Hong Kong, Queen Elizabeth Hospital, Hong Kong, The University of Hong Kong, Tseung Kwan O Hospital, Tuen Mun Hospital, Tung Wah Hospital, United Christian Hospital |
Hong Kong,
Babjuk M, Böhle A, Burger M, Capoun O, Cohen D, Compérat EM, Hernández V, Kaasinen E, Palou J, Rouprêt M, van Rhijn BWG, Shariat SF, Soukup V, Sylvester RJ, Zigeuner R. EAU Guidelines on Non-Muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol. 2017 Mar;71(3):447-461. doi: 10.1016/j.eururo.2016.05.041. Epub 2016 Jun 17. — View Citation
Divrik RT, Sahin AF, Yildirim U, Altok M, Zorlu F. Impact of routine second transurethral resection on the long-term outcome of patients with newly diagnosed pT1 urothelial carcinoma with respect to recurrence, progression rate, and disease-specific survival: a prospective randomised clinical trial. Eur Urol. 2010 Aug;58(2):185-90. doi: 10.1016/j.eururo.2010.03.007. Epub 2010 Mar 19. — View Citation
Grimm MO, Steinhoff C, Simon X, Spiegelhalder P, Ackermann R, Vogeli TA. Effect of routine repeat transurethral resection for superficial bladder cancer: a long-term observational study. J Urol. 2003 Aug;170(2 Pt 1):433-7. — View Citation
Jahnson S, Wiklund F, Duchek M, Mestad O, Rintala E, Hellsten S, Malmström PU. Results of second-look resection after primary resection of T1 tumour of the urinary bladder. Scand J Urol Nephrol. 2005;39(3):206-10. — View Citation
Kramer MW, Rassweiler JJ, Klein J, Martov A, Baykov N, Lusuardi L, Janetschek G, Hurle R, Wolters M, Abbas M, von Klot CA, Leitenberger A, Riedl M, Nagele U, Merseburger AS, Kuczyk MA, Babjuk M, Herrmann TR. En bloc resection of urothelium carcinoma of the bladder (EBRUC): a European multicenter study to compare safety, efficacy, and outcome of laser and electrical en bloc transurethral resection of bladder tumor. World J Urol. 2015 Dec;33(12):1937-43. doi: 10.1007/s00345-015-1568-6. Epub 2015 Apr 25. — View Citation
Lazica DA, Roth S, Brandt AS, Böttcher S, Mathers MJ, Ubrig B. Second transurethral resection after Ta high-grade bladder tumor: a 4.5-year period at a single university center. Urol Int. 2014;92(2):131-5. doi: 10.1159/000353089. Epub 2013 Aug 23. — View Citation
Sylvester RJ, van der Meijden AP, Oosterlinck W, Witjes JA, Bouffioux C, Denis L, Newling DW, Kurth K. Predicting recurrence and progression in individual patients with stage Ta T1 bladder cancer using EORTC risk tables: a combined analysis of 2596 patients from seven EORTC trials. Eur Urol. 2006 Mar;49(3):466-5; discussion 475-7. Epub 2006 Jan 17. — View Citation
Ukai R, Kawashita E, Ikeda H. A new technique for transurethral resection of superficial bladder tumor in 1 piece. J Urol. 2000 Mar;163(3):878-9. — View Citation
Vasdev N, Dominguez-Escrig J, Paez E, Johnson MI, Durkan GC, Thorpe AC. The impact of early re-resection in patients with pT1 high-grade non-muscle invasive bladder cancer. Ecancermedicalscience. 2012;6:269. doi: 10.3332/ecancer.2012.269. Epub 2012 Sep 18. — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | One-year recurrence rate | Rate of disease recurrence one year after the operation | One year after the allocated treatment | |
Secondary | Detrusor muscle sampling rate | Rate of presence of detrusor muscle in the pathological specimen | One week after the allocated treatment | |
Secondary | Occurrence of obturator reflex | Number of participants with obturator reflex encountered by the operating surgeon during the operation | Intra-operative | |
Secondary | Operative time | Duration of operation | Immediately post-operative | |
Secondary | Rate of mitomycin C instillation | Rate of mitomycin C instillation given after the operation | One day after the allocated treatment | |
Secondary | Hospital stay | Patients undergoing transurethral resection surgery have an average hospital stay of three days. | Three days after the allocated treatment | |
Secondary | 30-day complications | Complications which occur within 30 days after the operation | Thirty days after the allocated treatment | |
Secondary | Residual disease upon second look transurethral resection surgery | Second look transurethral resection surgery is expected to perform within six weeks after the allocated treatment and one more week is allowed for histological assessment of the second look transurethral resection specimen. Residual disease is measured by the number of participants with the presence of urothelial carcinoma in the second look transurethral resection specimen. | Seven weeks after the allocated treatment | |
Secondary | Upstaging of disease upon second look transurethral resection surgery | Second look transurethral resection surgery is expected to perform within six weeks after the allocated treatment and one more week is allowed for histological assessment of the second look transurethral resection specimen. Upstaging of disease is measured by the number of participants with upstaging of disease from non-muscle-invasive bladder cancer to muscle-invasive bladder cancer in the second look transurethral resection specimen. | Seven weeks after the allocated treatment | |
Secondary | One-year progression rate | Rate of disease progression one year after the operation | One year after the allocated treatment |
Status | Clinical Trial | Phase | |
---|---|---|---|
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