Observation Versus Immediate Surgery of Low Risk Bladder Cancer

August 9, 2018 updated by: Daniel Lee, Vanderbilt University Medical Center
This trial is a randomized, multi-center, non-inferiority study comparing observation versus immediate surgery for low grade, noninvasive bladder cancer.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

8

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Tennessee
      • Nashville, Tennessee, United States
        • Vanderbilt University Medical Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

50 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • History of low grade, noninvasive urothelial carcinoma of the bladder with a new recurrence that meets the following criteria:
  • total tumor burden ≤3cm in size (multiple lesions permitted)
  • low grade appearance (grade 1 or grade 2)
  • noninvasive appearance (Ta)
  • no history of carcinoma in situ (CIS) or lesions concerning for CIS
  • negative urine cytology (atypical or suspicious for low grade neoplasm are acceptable)

Exclusion Criteria:

  • High grade and/or invasive and/or carcinoma in situ disease
  • Concomitant upper tract urothelial carcinoma
  • Any patient who is pregnant or who may have plans to become pregnant.
  • Positive cytology

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Other: Observation
Patients will not undergo immediate surgery. These patients will undergo surveillance cystoscopy and urinary cytology every 3 months for 12 months. Surgery will commence after 12 months of observation or sooner if cystoscopic evidence of disease progression or patient desire.
Other: Observation
Other Names:
  • Active Surveillance
Procedure: Surveillance Cystoscopy and Urinary Cytology
Cytology and cystoscopy are done at the same time
Other: Immediate Surgery
Patients will undergo immediate surgery. These patients will undergo surveillance cystoscopy and urinary cytology every 3 months for 12 months. Repeated surgery will be offered for additional recurrences.
Procedure: Surveillance Cystoscopy and Urinary Cytology
Cytology and cystoscopy are done at the same time
Other: Immediate Surgery
Other Names:
  • Transurethral Resection of Bladder Tumor

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Event-Free Survival
Time Frame: 12 months
An event is a complication of any kind, including bleeding requiring blood transfusion, bladder perforation, urinary tract infection, readmission to the hospital, and progression of disease.
12 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Proportion of patients with disease progression (either stage or grade)
Time Frame: 12 months
proportion of patients with disease progression (either stage or grade)
12 months
Patient-reported Costs
Time Frame: At baseline and 3 months, 6 months, 9 months and 12 months.
out of pocket medical costs
At baseline and 3 months, 6 months, 9 months and 12 months.
Self-reported patient anxiety measured using the EORTC QLQ-NMIBC24
Time Frame: At baseline and 3 months, 6 months, 9 months and 12 months.
Measured using the EORTC QLQ-NMIBC24, which is a 24-item questionnaire for patients with superficial bladder cancer. This will be assessed at baseline and every 3 months during the study.
At baseline and 3 months, 6 months, 9 months and 12 months.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Vanderbilt University Medical Center

Investigators

  • Principal Investigator: Daniel D. Lee, MD, Vanderbilt University Medical Center

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

April 1, 2016

Primary Completion (Actual)

July 19, 2018

Study Completion (Actual)

July 19, 2018

Study Registration Dates

First Submitted

December 7, 2015

First Submitted That Met QC Criteria

March 4, 2016

First Posted (Estimate)

March 7, 2016

Study Record Updates

Last Update Posted (Actual)

August 13, 2018

Last Update Submitted That Met QC Criteria

August 9, 2018

Last Verified

August 1, 2018

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 151898

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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