Lung Cancer Clinical Trial
Official title:
thoracoSCopic Versus OPen Lobectomy for Early Stage Lung Cancer: a Randomized Prospective Trial
In patients with early stage lung cancer surgical lobectomy is the treatment of choice. A resection by Video-assisted Thoracic Surgery (VATS) is probably superior to an open procedure by thoracotomy for patients with early stage lung cancer, but randomized evidence for superiority is lacking. Furthermore, VATS lobectomy has not gained broad implementation yet. The objective of this study is to assess the benefits of VATS- over open lobectomy regarding quality of life and costs in a prospective randomized controlled multicenter trial. All patients meeting the inclusion criteria that are not randomized will be included in a prospective Cohort.
Rationale: Surgical lobectomy is the treatment of choice for patients with early stage lung
cancer. In some centres, video-assisted thoracic surgery (VATS) lobectomy is preferred,
where other centres hold on to the conventional open lobectomy via a thoracotomy. Although
several studies have demonstrated fewer postoperative complications and shorter hospital
length of stay for the VATS procedure, others have reported concerns regarding oncologic
equivalence, mainly based on incomplete lymph node staging. Convincing randomized evidence
from the literature is lacking. The aim of this randomized multicentre study is to compare
quality of life, oncologic endpoints and cost-effectiveness between VATS- and open
(thoracotomy) lobectomy.
Objective: To compare quality of life, cost-effectiveness and number of dissected
mediastinal lymph nodes between open,VATS and ROBOT-assisted lobectomy.
Study design: A prospective multi-centre randomized trial with a prospective registry arm
Study population: Adult patients of either gender, selected by the pulmonary oncological
multidisciplinary team to undergo surgical lobectomy for early-stage lung carcinoma.
Intervention: One group is assigned to the open procedure: posterolateral thoracotomy for
lobectomy with mediastinal lymph node dissection. The other group is assigned to the VATS
procedure: thoracoscopic minimally invasive lobectomy with thoracoscopic mediastinal lymph
node dissection. All patients that do meet the inclusion criteria but are not participating
in the randomized trial can be included in the prospective Cohort arm of the study
evaluating clinical assignment to OPEN- VATS or ROBOT-assisted lobectomy.
Main study parameters/endpoints: Primary endpoints are postoperative quality of life, and
hospital length of stay. Secondary endpoints include cancer specific quality of life, number
of dissected mediastinal lymph nodes and stations, procedural complication rates, pulmonary
function, overall costs and survival.
Centres participating in this study currently perform the open- and VATS and/or
ROBOT-assisted lobectomy in daily clinical practice.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment
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