Lung Neoplasms Clinical Trial
Official title:
VIdeo Assisted Thoracoscopic Lobectomy Versus Conventional Open LobEcTomy for Lung Cancer, a Multi-centre Randomised Controlled Trial With an Internal Pilot
Lung cancer is the leading cause of cancer death worldwide and survival in the United Kingdom (UK) remains amongst the lowest in Europe. Surgery is the main method of managing early stage disease and is traditionally undertaken via conventional open surgery. However, over the last decade there has been a surge in the number of minimal access resections performed using Video-assisted thoracoscopic surgery (VATS). However, there remains a need for well-designed and conducted randomised controlled trial (RCT) to provide the evidence base for the wide spread uptake and delivery of this surgical approach.
The uptake of surgery for lung cancer in the UK is low and minimal access surgery may be
regarded as a more acceptable intervention (compared to open surgery) by patients, referring
respiratory physicians and oncologists. However, a large multi-centre RCT is essential to
inform patient and clinician decision making and influence surgical practice in the UK.
The VIOLET study will compare the effectiveness, cost-effectiveness and acceptability of VATS
lobectomy versus open surgery for treatment of lung cancer and will test the hypothesis that
VATS surgery is superior to open surgery with respect to self-reported physical function five
weeks after randomisation (approx. one month after surgery).
Specific objectives are to estimate:
A. The difference between groups in the average self-reported physical function at five
weeks.
B. The difference between groups with respect to a range of secondary outcomes including
assessment of efficacy (hospital stay, pain, proportion and time to uptake of chemotherapy),
measures of safety (adverse health events), oncological outcomes (proportion of patients
upstaged to pN2 disease and disease free survival) and overall survival.
C. The cost effectiveness of VATs and open surgery.
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