EUS-guided RFA for Solid Abdominal Neoplasms
Multi-center Prospective Study on EUS-guided Radiofrequency Ablation for Solid Abdominal Neoplasms.
Radiofrequency ablation has been used for treatment of solid neoplasms of the liver, lung, kidney and adrenal. Recently, EUS-guided RFA has become available and the device allows EUS-guided treatment of solid abdominal neoplasms. The procedure has been shown to be feasible in the porcine pancreas and was used to treat small groups of patients that are not suitable for surgery suffering from pancreatic cancers.
The aim of the current study is to perform a multi-center prospective study on EUS-guided radiofrequency ablation (RFA) of solid abdominal neoplasms. The hypothesis is that EUS-guided RFA is safe, feasible and effective for treating solid abdominal neoplasms.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
RFA causes tissue destruction through the application of a high frequency alternating current, generating local temperatures above 60°C and leading to coagulative necrosis. The technique has been widely used in many solid organ tumours and has been shown to result in 5-year survival rates comparable to surgery. The technique is currently the standard therapy in hepatocellular carcinoma and colorectal pulmonary metastasis particular in patients that are not suitable for surgery.
The current study would be a multi-center prospective study involving four high volume international institutions. Consecutive patients suffering from solid neoplasms of the liver, stomach and adrenals would be recruited. EUS-guided RFA would be performed using a 19-gauge RFA electrode and a VIVA RF generator (STARmed, Korea). The primary outcome would be the overall adverse events rate. Secondary outcomes include mortality, technical success rate, completion ablation rate, 1 & 3 year overall and disease-free survival.
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Anthony YB Teoh, Professor
- Phone Number: 26322956
- Email: anthonyteoh@surgery.cuhk.edu.hk
Study Locations
-
-
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Hong Kong, Hong Kong
- Recruiting
- Department of Surgery, Prince of Wales Hospital
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Contact:
- Anthony YB Teoh, FRCSEd(Gen)
- Phone Number: 85226322953
- Email: anthonyteoh@surgery.cuhk.edu.hk
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Principal Investigator:
- Anthony YB Teoh
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18 years-old or above
- Suffering from solid neoplasms of the stomach, liver, kidney or adrenals (<5cm in largest diameter) that is indicated for treatment.
Unsuitable for surgery, due to one (or more) of the following items:
- ASA score > II*
- An alternative advanced malignancy
- Unsuitable for surgery upon expert's opinion for any other reason
- Healthy individuals who are not keen for surgical resection
- Eligible for endoscopic intervention
- Written informed consent
Exclusion Criteria:
- Coagulopathy (international normalized ratio >1.3, partial thromboplastin time greater than twice that of control), platelet count <50,000x103/uL
- Pregnancy
- Patients with a poor mental condition or mental retardation, unable to understand the nature and possible consequences of the study
- Patients unwilling to undergo follow-up assessments
- Patients with liver cirrhosis, portal hypertension and/or gastric varices.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: EUS-guided RFA
EUS-guided RFA would be performed using a 19-gauge RFA electrode and a VIVA RF generator (STARmed, Korea).
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All patients would undergo EUS with a linear array echoendoscope.
The location and size of the lesion would be assessed for suitability of treatment.
After locating the lesion, the RFA needle would be inserted to the centre of the lesion.
RFA would then be initiated and hyperechoic interferences would be observed around the electrode signifying heating of the tissue.
The duration of ablation would be according to the size of the lesion.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Severe adverse events
Time Frame: 30 days
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Adverse events specific to RFA would be graded according to the lexicon of endoscopic adverse events 24.
Potential adverse events specific to RFA include: post-RFA syndrome, pancreatitis, pancreatic leak and thermal injury.
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30 days
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Technical success rates
Time Frame: 1 week
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defined as successful puncture of the lesion with the RFA needle and completion of the ablation cycle.
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1 week
|
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Procedural times
Time Frame: 1 day
|
Duration of the procedure
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1 day
|
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Hospital stay
Time Frame: 30 days
|
Duration of hospital stay after the procedure
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30 days
|
|
Radiological response
Time Frame: 1 year
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Based on a modified RECIST criterion
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1 year
|
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Number of re-interventions
Time Frame: 1 year
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The number of re-interventions after RFA
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1 year
|
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Survival
Time Frame: 3 years
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The duration of survival after the procedure
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3 years
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Anthony YB Teoh, Professor, Chinese University of Hong Kong
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
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
Keywords
Additional Relevant MeSH Terms
- Urogenital Diseases
- Urogenital Neoplasms
- Neoplasms by Site
- Neoplasms
- Male Urogenital Diseases
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Neoplasms by Histologic Type
- Digestive System Diseases
- Neoplasms, Glandular and Epithelial
- Adenocarcinoma
- Urologic Neoplasms
- Carcinoma
- Kidney Neoplasms
- Carcinoma, Renal Cell
- Digestive System Neoplasms
Other Study ID Numbers
Other Study ID Numbers
- CRE-2015.707
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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