Trial of Modifications to Radical Prostatectomy
A Randomized Trial of Modifications to Radical Prostatectomy
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 3
Contacts and Locations
Study Contact
Study Contact
- Name: Andrew Vickers, PhD
- Phone Number: 646-888-8233
Study Contact Backup
- Name: Behfar Ehdaie, MD, PhD
- Phone Number: 646-422-4406
Study Locations
-
-
New Jersey
-
Basking Ridge, New Jersey, United States, 07920
- Memorial Sloan Kettering Cancer Center at Basking Ridge
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Montvale, New Jersey, United States, 07645
- Memorial Sloan Kettering Bergen (Consent Only)
-
-
New York
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Harrison, New York, United States, 10604
- Memorial Sloan Kettering Westchester
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New York, New York, United States, 10065
- Memorial Sloan Kettering Cancer Center
-
Uniondale, New York, United States, 11553
- Memorial Sloan Kettering Cancer Center @ Nassau (Consent only)
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients do not have to be eligible for both modifications to be included in the study.
Lymphadenectomy vs no lymphadenectomy:
- Patients 21 years or older scheduled for radical prostatectomy for treatment of prostate cancer with one of the consenting surgeons at MSKCC
Hemostatic agent vs. no hemostatic agent
- Patients 21 years or older scheduled for minimally invasive radical prostatectomy for the treatment of prostate cancer with one of the consenting surgeons at MSKC
Exclusion Criteria:
Lymphadenectomy vs no lymphadenectomy
- Presence of positive/suspicious pelvic nodes on MRI, CT or PSMA scan (positive/suspicious defined as a pelvic node >15mm in short axis on CT or MRI, a PSMA avid node, or a node with abnormal morphology such as roundness or irregularity or loss of fatty hilum)
- Any prior pelvic radiation therapy used to treat prostate cancer
Hemostatic agent vs. no hemostatic agent
- No additional exclusion criteria
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Factorial Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Lymphadenectomy vs. no lymphadenectomy
In patients randomized to standard, only the nodal packet under the external iliac vein and above the obturator nerve will be dissected.
For patients randomized to the modified template, the external iliac, hypogastric and obturator fossa nodal groups will be removed.No lymph nodes will be removed in patients randomized to the no PLND arm.
|
Inclusion of the external iliac, hypogastric and obturator fossa nodal groups in the template undergoing a Radical Prostatectomy.
Modifying the template for lymph node dissection may lead to removal of additional affected nodes, reducing the chance of recurrence.
.No lymph nodes will be removed in patients randomized to the no PLND arm.
|
|
Experimental: Transverse versus vertical closure of the port site incision (Closed as of 9/30/2021)
|
Transverse versus vertical closure of the port site incision
|
|
Experimental: One vs. three days of antibiotic prophylaxis (Closed as of 9/30/2021)
|
One vs. three days of antibiotic prophylaxis at catheter removal
|
|
Experimental: Hemostatic agent vs. no hemostatic agent
|
For the patients randomized to routine indwelling HA agent use, the operating surgeon may choose to use either Surgicel™, Surgicel SNoW™, Arista™, FloSeal or surgeon's choice HA directed at the prostatic fossa, ligated dorsal vein complex, or neurovascular bundles.
Because there is no standard HA or method of application, the surgeon will apply the HA according to the surgeon's experience and document both the HA used, and the location applied in the operative report.
For patients randomized to no routine indwelling HA use, surgeons will only apply a HA if they are unable to achieve hemostasis using traditional means or feel it would be unsafe to complete the operation without using a HA for additional hemostasis.
Providers in either arm may use HA as needed provided the intention is not to leave the HA indwelling.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Patient-reported hernia
Time Frame: 1 year
|
Patient-reported hernia is a routine assessment on post-operative questionnaires completed by prostate cancer patients at MSKCC.
The questionnaire asks about hernia near the surgical scar and if there has been a need for surgical repair of the hernia.
|
1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
To evaluate whether a modification to the template for lymph node dissection reduces biochemical recurrence rates
Time Frame: 2 years
|
Biochemical recurrence is defined as any postoperative PSA of 0.2 ng / mL or higher, or treatment with hormones, radiotherapy or chemotherapy starting six months or more after radical prostatectomy.
|
2 years
|
|
urinary tract infection (UTI)
Time Frame: within 10 days
|
urinary tract infection (UTI) within 10 days of catheter removal.
We will use the CDC's definition of UTI: symptomatic UTI diagnosed in patients with positive urine cultures (≥100,000 microorganisms per cm3) and at least one of the following signs or symptoms with no other recognized cause: fever (>38oC), urgency, frequency, dysuria or suprapubic tenderness.50
UTI is routinely captured by clinical staff as a surgical complication.
|
within 10 days
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Andrew Vickers, PhD, Memorial Sloan Kettering Cancer Center
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
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
- 11-096
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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