Modifications to Radical Prostatectomy: Feasibility Study
A Randomized Trial of Modifications to Radical Prostatectomy: Feasibility Study
This study aims to determine whether surgeons at Memorial Sloan-Kettering Cancer Center are able to randomize patients to test modifications of surgery to remove the prostate. Surgery to remove the prostate is known as a "radical prostatectomy". Surgeons know many things about the best way to do a radical prostatectomy. However, there is disagreement about some aspects of surgery. Two modifications of surgery to remove the prostate (radical prostatectomy) identified for this study include Irrigation, and Fascial Suturing.
Two aspects of the operation may vary, fascial suturing and urethral irrigation. For each aspect, surgeons will use their clinical judgment as to the best interests of the patient. In other words, if there are clear reasons to use or avoid a fascial suturing approach, the surgeon will act accordingly; similarly, if there is a clear reason to irrigate or avoid irrigating the urethra, the surgeon can make the appropriate clinical decision. If the surgeon is unsure as to which approach to take, then the randomization scheme will be followed.
All of the surgeons who are taking part in this study have used these techniques at different times. However, they are unsure as to the best approach. Sometimes, they use different treatments with different patients.
Irrigation. Cancer cells can spill during surgery and this can cause cancer to return ("recur"). Some surgeons believe that "irrigating" could help stop spilling of cancer cells. "Irrigating" means washing the surgical area with sterile water and sucking the water back up through a tube. As a result, surgeons vary as to how they irrigate. In this study, we will examine irrigation of the urethra. This is the part of the body that carries urine from the bladder to the penis.
Fascial suturing. Surgeons believe that what happens to the urethra can affect the risk of incontinence. This is when a patient cannot control urine, and drips or leaks urine. One idea is that additional stitches ("sutures") to the connective tissue ("fascia") could be helpful, but this is not known for sure.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
- Procedure: radical prostatectomy with urethral irrigation but no fascial suturing, QOL forms
- Procedure: radical prostatectomy with fascial suturing but no urethral irrigation, QOL forms
- Procedure: radical prostatectomy with both urethral irrigation and fascial suturing, QOL forms
- Procedure: radical prostatectomy with neither urethral irrigation nor fascial suturing, QOL forms
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
New York
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients scheduled for radical prostatectomy for the treatment of prostate cancer with one of the consenting surgeons at MSKCC.
Exclusion Criteria:
- Prior treatment for prostate cancer: radiation, hormonal therapy, chemotherapy or focal therapy.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: urethral irrigation but no fascial suturing, QOL forms
The anterior two-thirds of the urethra is divided exposing a Foley catheter that was placed at the beginning of the procedure.
Irrigation of the urethra may prevent spread of prostate cancer cells to tissue that is not removed during surgery.
The urethra is irrigated with 60 cc of sterile water as it is withdrawn from the patient to 'wash' the urethra.
|
Cancer cells can spill during surgery and this can cause cancer to return ("recur").
Some surgeons believe that "irrigating" could help stop spilling of cancer cells.
"Irrigating" means washing the surgical area with sterile water and sucking the water back up through a tube.
As a result, surgeons vary as to how they irrigate.
In this study, we will examine irrigation of the urethra.
This is the part of the body that carries urine from the bladder to the penis.
Quality of life are assessed for clinical evaluation approximately 3, 6, 9, 12, 18, 24, 36 and 48 months after surgery
|
|
Active Comparator: fascial suturing but no urethral irrigation, QOL forms
For patients undergoing fascial suturing only, after the initial placement of the suture through the urethra a second bite is taken deeply into the fascia of the lateral pelvic fascia.
|
Surgeons believe that what happens to the urethra can affect the risk of incontinence.
This is when a patient cannot control urine, and drips or leaks urine.
One idea is that additional stitches ("sutures") to the connective tissue ("fascia") could be helpful, but this is not known for sure.
Quality of life are assessed for clinical evaluation approximately 3, 6, 9, 12, 18, 24, 36 and 48 months after surgery
|
|
Active Comparator: both urethral irrigation and fascial suturing, QOL forms
|
Quality of life are assessed for clinical evaluation approximately 3, 6, 9, 12, 18, 24, 36 and 48 months after surgery
|
|
Active Comparator: neither urethral irrigation nor fascial suturing, QOL forms
|
Quality of life are assessed for clinical evaluation approximately 3, 6, 9, 12, 18, 24, 36 and 48 months after surgery
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
To pilot a randomized trial of modifications to radical prostatectomy to determine:Proportion of patients accrued and Accrual rate
Time Frame: 1 year
|
1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Determine surgeon compliance with allocation
Time Frame: 1 year
|
1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Andrew Vickers, MD, Memorial Sloan Kettering Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 09-051
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