Video-Assisted Surgery or Talc Pleurodesis in Treating Patients With Malignant Mesothelioma
| Sponsored by: | Papworth Hospital |
|---|---|
| Information provided by: | National Cancer Institute (NCI) |
| ClinicalTrials.gov Identifier: | NCT00821860 |
Purpose
RATIONALE: Video-assisted surgery to remove part of the tissue layer covering the inside of the chest cavity may be effective in treating pleural effusion and cause less damage to normal tissue. Talc pleurodesis may keep fluid from building up in the chest cavity. It is not yet known which therapy is more effective in treating pleural effusion caused by malignant mesothelioma.
PURPOSE: This randomized phase III trial is studying video-assisted surgery to see how well it works compared with talc pleurodesis in treating patients with malignant mesothelioma.
| Condition | Intervention | Phase |
|---|---|---|
| Malignant Mesothelioma Metastatic Cancer |
Other: talc Procedure: therapeutic thoracoscopic surgery Procedure: therapeutic thoracoscopy Procedure: therapeutic videothoracoscopy |
Phase III |
| Study Type: | Interventional |
| Study Design: | Treatment, Randomized, Active Control |
| Official Title: | Prospective Randomised Controlled Trial of Video-Assisted Thoracoscopic (VAT) Cytoreductive Pleurectomy Compared to Talc Pleurodesis in Patients With Suspected or Proven Malignant Mesothelioma |
- Survival at 1 year after treatment [ Designated as safety issue: No ]
- Control of pleural effusion [ Designated as safety issue: No ]
- Complications, including need for more surgery, persistent air leak requiring pleural intubation for > 10 days, and hospital stay for > 12 days [ Designated as safety issue: No ]
- Symptoms and quality of life as assessed by the EuroQol questionnaire [ Designated as safety issue: No ]
- Length of hospital stay [ Designated as safety issue: No ]
- Exercise tolerance [ Designated as safety issue: No ]
- Cost to the health service, in terms of resources used for procedures, hospital bed usage, and cost of primary and secondary care over 12 months [ Designated as safety issue: No ]
| Estimated Enrollment: | 196 |
| Study Start Date: | September 2003 |
| Estimated Primary Completion Date: | August 2011 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Arm I: Experimental
Patients undergo video-assisted thoracoscopic cytoreductive pleurectomy either at the time of biopsy or after confirmation of biopsy results.
|
Procedure: therapeutic thoracoscopic surgery
Video-assisted thoracoscopic pleurectomy
Procedure: therapeutic videothoracoscopy Video-assisted thoracoscopic pleurectomy
|
| Arm II: Active Comparator
Patients undergo talc pleurodesis via an indwelling intercostal chest drain or via thoracoscopy either at the time of biopsy or after confirmation of biopsy results.
|
Other: talc
Talc pleurodesis
Procedure: therapeutic thoracoscopy Talc pleurodesis via thoracoscopy
|
OBJECTIVES:
Primary
- Compare the effectiveness of video-assisted thoracoscopic cytoreductive pleurectomy vs talc pleurodesis, in terms of 1-year survival, in patients with suspected or proven malignant mesothelioma.
Secondary
- Compare the control of pleural effusion in these patients.
- Compare procedure-related complications in these patients.
- Compare the symptoms and quality of life of these patients at 3, 6, and 12 months after treatment.
- Compare the length of hospital stay for these patients.
- Compare the exercise tolerance of these patients at 3, 6, and 12 months after treatment.
- Determine the cost to the health service, in terms of resources used for procedures, hospital bed usage, and cost of primary and secondary care over 12 months.
OUTLINE: This is a multicenter study. Patients are stratified according to risk (high vs low). Patients are randomized to 1 of 2 treatment arms.
- Arm I (video-assisted thoracoscopic [VAT] cytoreductive pleurectomy): Patients undergo VAT cytoreductive pleurectomy either at the time of biopsy or after confirmation of biopsy results.
- Arm II (talc pleurodesis): Patients undergo talc pleurodesis via an indwelling intercostal chest drain or via thoracoscopy either at the time of biopsy or after confirmation of biopsy results.
Quality of life, complications, and resource use are assessed at baseline and at 1, 3, 6, and 12 months.
Eligibility
| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
DISEASE CHARACTERISTICS:
-
Confirmed or suspected mesothelioma
- Any subtype allowed
- Pleural effusion must be present
PATIENT CHARACTERISTICS:
- Clinically fit and suitable for video-assisted thoracoscopic cytoreductive pleurectomy
- Prior malignancy allowed provided it no longer requires treatment AND patient has a confirmed diagnosis of mesothelioma
PRIOR CONCURRENT THERAPY:
- No prior attempted pleurodesis by any approach
Contacts and Locations
| United Kingdom, England | |
| Basildon University Hospital | Recruiting |
| Basildon, England, United Kingdom, SS16 5NL | |
| Contact: Contact Person 44-1268-533-911 | |
| Glenfield Hospital | Recruiting |
| Leicester, England, United Kingdom, LE3 9QP | |
| Contact: Contact Person 44-116-287-1471 | |
| Guy’s Hospital | Recruiting |
| London, England, United Kingdom, SE1 9RT | |
| Contact: Contact Person 44-20-7188-7188 | |
| Papworth Hospital | Recruiting |
| Cambridge, England, United Kingdom, CB3 8RE | |
| Contact: Contact Person 44-1480-364-821 | |
| Royal Hallamshire Hospital | Recruiting |
| Sheffield, England, United Kingdom, S1O 2JF | |
| Contact: Contact Person 44-114-271-1900 | |
| Principal Investigator: | Robert Winter, MD | Papworth Hospital |
More Information
Additional Information:
No publications provided
| Study ID Numbers: | CDR0000630699, PAPWORTH-MESOVAT, PAPWORTH-P00804, EU-20901, ISRCTN34321019 |
| Study First Received: | January 13, 2009 |
| Last Updated: | June 9, 2009 |
| ClinicalTrials.gov Identifier: | NCT00821860 History of Changes |
| Health Authority: | Unspecified |
Keywords provided by National Cancer Institute (NCI):
| advanced malignant mesothelioma epithelial mesothelioma localized malignant mesothelioma |
recurrent malignant mesothelioma sarcomatous mesothelioma malignant pleural effusion |
Study placed in the following topic categories:
| Pleural Effusion Neoplasm Metastasis Pleural Effusion, Malignant Mesothelioma |
Adenoma Recurrence Neoplasms, Glandular and Epithelial |
Additional relevant MeSH terms:
| Neoplastic Processes Neoplasms Pathologic Processes Neoplasms by Histologic Type Mesothelioma |
Neoplasms, Mesothelial Neoplasm Metastasis Adenoma Neoplasms, Glandular and Epithelial |
ClinicalTrials.gov processed this record on August 10, 2009
Source: http://www.clinicaltrials.gov
