使用重新设计的手术电切镜设备对膀胱肿瘤 (En-bloc TURBT) 标本进行整块经尿道切除术
使用重新设计的手术电切镜装置对膀胱肿瘤 (En-bloc TURBT) 标本进行整块经尿道切除术的体外试验
Background:
Bladder cancer is the sixth most common cancer in the United States. The way that doctors remove tumors in bladder surgeries may leave some cancer . Also, many people have their tumors return or progress after surgery. Researchers want to test a modified device. It might tell doctors more about bladder tumors.
Objective:
To see if using a modified standard device with bladder surgery can provide better information about tumors in bladder specimens.
Eligibility:
People ages 18 and older who need to have their bladder removed at the NIH.
Design:
Participants will be screened with:
Medical and prior surgical history
Review of existing MRI, x-ray, or CT scans
Review of existing specimens and reports
Pregnancy test for women of childbearing age
CT or MRI: Participants will lie in a machine. The machine will take pictures of their body.
Participants will have bladder surgery. This will occur in the same way as if they did not take part in this study. A member of the research team will cut the removed bladder using the modified device. This will most likely be done on a separate back table in the operating room. The bladder and samples after cutting will be sent out for review. The will occur just as it would if the participants were not in this study. The only difference is the way that the specimen is prepared for review.
Participants follow-up care will occur per standard of care. Or it will occur as part of any other study in which they might also be enrolled.
研究概览
详细说明
Background:
- Bladder cancer is the sixth most common cancer in the United States, disproportionately affecting more men than women.
- The gold standard for the surgical treatment and diagnosis of non-muscle invasive bladder cancer is transurethral resection of bladder tumors (TURBT).
- TURBT requires the fragmentation of bladder tumors and piecemeal removal of these tumors.
- TURBT leads to loss of histopathologic information - including tumor orientation, size, and margin status - which may compromise outcomes and risk tumor seeding within the bladder.
- Given these multiple problems with TURBT we are testing some modifications to the current resectoscope device and the effect of these modifications on the quality of TURBT specimens produced.
- The redesigned resectoscope device will be tested ex-vivo on cystectomy specimens to avoid risks to patient safety.
Objectives:
The primary objective of this study is to determine if resectoscope device modification can provide improved pathologic standards for the TURBT procedure. An improvement in any of the parameters outlined below will constitute a device improvement in the current resectoscope:
- Presence of three tissue layers within the tumor specimens containing bladder mucosa, lamina propria, and portions of the muscularis.
- Information regarding tumor margin, assessed as the ability to ascertain if tumor is present at the margin of the resection.
Eligibility:
- Medical condition requiring surgical removal of the bladder
- Men and women, age >= 18 years
Design:
- Preclinical tissue acquisition trial, ex vivo, proof-of-concept.
- Following cystectomy, a modified resectoscope/redesigned resectoscope will be used to resect areas of tumor from the cystectomy specimens. These resected tumors will be sent with the cystectomy specimen for histopathology to assess the size of resection, depth of resection, and ability to ascertain tumor orientation.
- The remainder of the cystectomy specimens will undergo traditional histopathology. Histopathologic information from both specimens will be included in the final histopathologic diagnosis to ensure accurate oncology staging.
- This study will allow for about 2 years of accrual and the accrual ceiling will be set at 25 subjects.
研究类型
注册 (估计的)
联系人和位置
学习联系方式
- 姓名：NCI Medical Oncology Referral Office
- 电话号码：(240) 760-6050
- 邮箱：ncimo_referrals@nih.gov
研究联系人备份
- 姓名：Raju R Chelluri, M.D.
- 电话号码：(240) 858-3700
- 邮箱：raju.chelluri@nih.gov
学习地点
-
-
Maryland
-
Bethesda、Maryland、美国、20892
- 招聘中
- National Institutes of Health Clinical Center
-
接触：
- For more information at the NIH Clinical Center contact National Cancer Institute Referral Office
- 电话号码：888-624-1937
-
-
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
Bladder Cancer Patients
描述
- INCLUSION CRITERIA:
- Patients requiring surgical removal of the bladder at the NIH Clinical Center.
NOTE: Reasons for need for surgical removal of bladder include cancer or benign condition for which a surgeon determined surgical removal of the bladder is recommended. Patient's with invasive bladder cancer requiring cystectomy are eligible for enrollment. Bladder cancer remains the most common reason for cystectomy. Patients with clinical advanced disease and having other treatments/or participating in other trials remain eligible for enrollment in this study.
- Men and women
- Age greater than or less than 18 years
- Deemed clinically appropriate for the planned surgical procedure.
- Ability of subject to understand and the willingness to sign a written informed consent document.
- Subjects will be asked to co-enroll in 15-C-0087, "Care of the Urothelial Cancer Patient and Prospective Collection of Biospecimens from Healthy Volunteers and Urothelial Cancer Patients." NOTE: Most participants are expected to already be enrolled in 15-C-0087 prior to entry in this study.
EXCLUSION CRITERIA:
- Cystectomy during pregnancy would subject the fetus to significant risk of miscarriage or premature labor. For this reason, pregnant women are ineligible for this study.
学习计划
研究是如何设计的？
设计细节
- 观测模型：COHORT
- 时间观点：PROSPECTIVE
队列和干预
团体/队列 |
干预/治疗 |
|---|---|
|
1/ Cohort 1
Bladder Cancer Patients |
The modified resectoscope will be used post cystectomy (En-bloc TURBT) to resect areas of the tumor from the cystectomy specimen. These resected tumors will be sent for histopathology to assess the size of resection, depth of resection, and ability to ascertain tumor orientation and compared to the remainder of the cystectomy specimens to see if the modified resectoscope can provide improved pathologic standards for the TURBT procedure. All patients will receive routine surgical transurethral resection of bladder tumors (TURBT). |
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Assessment of resectoscope device modification on pathologic standards for the TURBT procedure
大体时间：Time of surgery/pathologic assessment (7-10 days)
|
-Presence of three tissue layers with in the tumor specimens containing bladder mucosa, lamina propria, and portions of the muscularis.-Information regarding tumor margin, assessed as the ability to ascertain if tumor is present at the margin of the resection. |
Time of surgery/pathologic assessment (7-10 days)
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Assessment for possible bladder perforation in bladder specimens
大体时间：Time of surgery/pathologic assessment (7-10 days)
|
The rate of occurrence will be described/tabulated. |
Time of surgery/pathologic assessment (7-10 days)
|
合作者和调查者
调查人员
- 首席研究员：Raju R Chelluri, M.D.、National Cancer Institute (NCI)
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
关键字
其他相关的 MeSH 术语
其他研究编号
- 200020
- 20-C-0020
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)？
IPD 计划说明
All IPD recorded in the medical record will be shared with intramural investigators upon request.
IPD 共享时间框架
Clinical data available during the study and indefinitely.
IPD 共享访问标准
Clinical data will be made available via subscription to BTRIS and with the permission of the study PI.
IPD 共享支持信息类型
- 研究方案
- 树液
- 国际碳纤维联合会
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
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