Robottiavusteinen vs. videoavusteinen lobektomia NSCLC:lle (RAVAR) (RAVAR)
Robottiavusteinen vs. videoavusteinen lobektomia ei-pienisoluiseen keuhkosyöpään (RAVAR): monikeskus, avoin, satunnaistettu, ei-alempiarvoisuuskoe
Video-assisted thoracic surgery (VATS) has been recommended by clinical guidelines as one of the preferred surgeries for early-stage non-small cell lung cancer (NSCLC) for many years. However, VATS has inherent drawbacks, so at the beginning of this century, robotic-assisted thoracoscopic surgery (RATS) was first applied for lung resection. In recent years, RATS has developed rapidly, but there are still many unsolved scientific problems in the field of RATS. Thus, a multicenter prospective randomized controlled trial was conducted with stage I-II NSCLC patients as the study subject and 5-year DFS as the primary endpoint to compare the short-term and long-term outcomes of RATS and VATS in the treatment of early-stage NSCLC.
Tutkimuksen yleiskatsaus
Tila
Interventio / Hoito
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskelupaikat
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Chongqing Municipality
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Chongqing, Chongqing Municipality, Kiina, 400014
- First Affiliated Hospital of Chongqing Medical University
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Gansu
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Lanzhou, Gansu, Kiina, 730030
- The Second Hospital of Lanzhou University
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Lanzhou, Gansu, Kiina, 730000
- Gansu Provincial Hospital
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Guangdong
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Guangzhou, Guangdong, Kiina, 510060
- Sun Yat-sen University Cancer Center
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Guangzhou, Guangdong, Kiina, 510080
- Guangdong Provincial People's Hospital
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Shenzhen, Guangdong, Kiina, 518020
- Shenzhen People's Hospital
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Shenzhen, Guangdong, Kiina, 518112
- Shenzhen Third People's Hospital
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Guangxi
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Guilin, Guangxi, Kiina, 541002
- Guangxi Nanxishan Hospital
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Henan
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Zhengzhou, Henan, Kiina, 450052
- The First Affiliated Hospital of Zhengzhou University
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Hubei
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Wuhan, Hubei, Kiina, 430022
- Wuhan Union Hospital
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Wuhan, Hubei, Kiina, 430030
- Wuhan TongJi Hospital
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Jiangsu
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Nanjing, Jiangsu, Kiina, 210009
- Jiangsu Cancer Institute & Hospital
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Nanjing, Jiangsu, Kiina, 210002
- The General Hospital of Eastern Theater Command
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Jiangxi
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Nanchang, Jiangxi, Kiina, 330006
- The First Affiliated Hospital of Nanchang University
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Nanchang, Jiangxi, Kiina, 330006
- Jiangxi Provincial People's Hopital
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Liaoning
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Shenyang, Liaoning, Kiina, 110042
- Liaoning Tumor Hospital & Institute
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Shaanxi
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Xi'an, Shaanxi, Kiina, 710038
- Tang-Du Hospital
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Shandong
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Jinan, Shandong, Kiina, 250012
- Qilu Hospital of Shandong University
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Jinan, Shandong, Kiina, 250014
- Qianfoshan Hospital
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Jinan, Shandong, Kiina, 250022
- Shandong Provincial Hospital
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Qingdao, Shandong, Kiina, 266003
- The Affiliated Hospital of Qingdao University
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Sichuan
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Chengdu, Sichuan, Kiina, 610041
- West China Hospital
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Chengdu, Sichuan, Kiina, 610041
- Sichuan Cancer Hospital and Research Institute
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
- Age from 18 to 80 years old;
- Patients with blood pressure<160/100mmHg, 5.6<blood glucose<11.2mmol/L, major organs function normally: (1) Goldman index between grade 1 and 2; (2) Predicted forced expiratory volume in 1s (FEV1) >= 40 % and diffusing capacity of the lung for carbon monoxide (DLCO) >= 40 %; (3) total bilirubin <= 1.5 upper limit of normal; (4) Alanine aminotransferase (ALT)/Aspartate aminotransferase (AST) <= 2.5 upper limit of normal; (5) creatinine <= 1.25 upper limit of normal and creatinine clearance rate (CCr) >= 60ml/min;
- The first clinical diagnosis before surgery was non-small cell lung cancer, including adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and other unknown types;
- Clinical stage T1-2N0-1 (cI-II): Maximum diameter of tumor <= 5cm and short diameter of mediastinal lymph node <= 1cm in thin layer CT;
- Performance status of Eastern Cooperative Oncology Group (ECOG) 0-1;
- All relevant examinations were completed within 28 days before the operation;
- Patients who understand this study and have signed an approved Informed Consent.
Exclusion Criteria:
- Patients with radiotherapy, chemotherapy, targeted therapy, or immunotherapy before surgery.
- Patients with the previous history of other malignancies;
- Patients with secondary primary cancer when enrolled;
- Patients diagnosed as pure ground glass opacity (GGO) before surgery;
- Patients diagnosed as mixed GGO whose solid part <= 50% and Maximum diameter of tumor <= 2cm;
- Patients with small cell lung cancer;
- Patients with prior unilateral open thoracic surgical procedures;
- Woman who is pregnant or breastfeeding;
- Patients with interstitial pneumonia, pulmonary fibrosis, or severe emphysema;
- Patients with an active bacterial or fungal infection that is difficult to control;
- Patients with serious psychosis;
- Patients with a history of severe heart attack, heart failure, myocardial infarction, or angina within the last 6 months.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Ei mitään (avoin tarra)
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
|
Kokeellinen: RATS group
Patients will receive robot-assisted lobectomy |
Patients will receive robot-assisted lobectomy using Da Vinci surgical system |
|
Active Comparator: VATS group
Patients will receive video-assisted lobectomy |
Patients will receive video-assisted lobectomy |
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
5-year disease-free survival (DFS)
Aikaikkuna: 5 years after surgery
|
Difference of 5-year disease free survival rate between the two groups |
5 years after surgery
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
5-year overall survival (OS)
Aikaikkuna: 5 years after surgery
|
Difference of 5-year overall survival rate between the two groups |
5 years after surgery
|
|
3-year disease-free survival (DFS)
Aikaikkuna: 3 years after surgery
|
Difference of 3-year disease free survival rate between the two groups |
3 years after surgery
|
|
3-year overall survival (OS)
Aikaikkuna: 3 years after surgery
|
Difference of 3-year overall survival rate between the two groups |
3 years after surgery
|
|
Blood loss
Aikaikkuna: During the surgery
|
Blood loss during the surgery |
During the surgery
|
|
Conversion rate
Aikaikkuna: During the surgery
|
The number of patients converted to thoracotomy divided by the total number of included patients in a group |
During the surgery
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Perioperative complication
Aikaikkuna: The day of surgery, 2/4/8/12/26/52 weeks after surgery
|
Intraoperative and postoperative complications |
The day of surgery, 2/4/8/12/26/52 weeks after surgery
|
|
Operative death rate
Aikaikkuna: 30/90 days after surgery
|
The number of patients died within 30/90 days after surgery divided by the total number of included patients in a group |
30/90 days after surgery
|
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Hospital stays after surgery
Aikaikkuna: Between the date of surgery and the date of discharge, assessed up to 30 days
|
The length of stay in hospital after surgery |
Between the date of surgery and the date of discharge, assessed up to 30 days
|
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Pain score after surgery
Aikaikkuna: Scores were given daily after surgery and at weeks 2/4/8/12/26/52 after discharge
|
The degree of pain after surgery was measured using Numerical Rating Scale (NRS). The patient is asked to make three pain ratings, corresponding to current, best and worst pain experienced over the past 24 hours on a scale of 0 (no pain) to 10 (worst pain imaginable). The average of the 3 ratings was used to represent the patient's level of pain over the previous 24 hours. |
Scores were given daily after surgery and at weeks 2/4/8/12/26/52 after discharge
|
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R0 rate
Aikaikkuna: Postoperative in-hospital stay up to 30 days
|
The number of patients received R0 surgery divided by the total number of included patients in a group |
Postoperative in-hospital stay up to 30 days
|
|
Operative time
Aikaikkuna: During the surgery
|
The total time from skin to skin and the time of each step were recorded |
During the surgery
|
|
The number of resected lymph nodes
Aikaikkuna: Postoperative in-hospital stay up to 30 days
|
The number of resected lymph nodes were calculated according to the official pathological report after surgery |
Postoperative in-hospital stay up to 30 days
|
|
Chest tube duration
Aikaikkuna: Postoperative in-hospital stay up to 30 days
|
The number of days between the date of surgery and the date of chest tube removal |
Postoperative in-hospital stay up to 30 days
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Acesodyne (Grade III) dose
Aikaikkuna: Postoperative in-hospital stay up to 30 days
|
The total amount of morphine used by the patient during the postoperative hospital stay, including morphine, pethidine, and fentanyl etc. |
Postoperative in-hospital stay up to 30 days
|
|
Total cost of hospitalization
Aikaikkuna: From the date of admission to the date of discharge, assessed up to 30 days
|
The total cost of the patient from admission to discharge |
From the date of admission to the date of discharge, assessed up to 30 days
|
Yhteistyökumppanit ja tutkijat
Sponsori
Yhteistyökumppanit
Tutkijat
- Päätutkija: Hao-Xian Yang, M.D., Sun Yat-Sen University Cancer Center
Julkaisuja ja hyödyllisiä linkkejä
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- SL-5010-2019-04
- ChiCTR2000034737 (Rekisterin tunniste: Chinese Clinical Trial Registry)
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