TURBt With Adjuvant Cryoablation to Treat Bladder Cancer

NCT ID: NCT02760953

Last Updated: 2017-10-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-10-19

Study Completion Date

2018-12-31

Brief Summary

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The purpose of this study is to evaluate the safety and efficacy of applying cryoablation as an adjuvant therapy with TUR to treat bladder tumor.

Detailed Description

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Bladder tumors are one of the most commonly diagnosed urinary tumors in the world. Worldwide, it has been estimated that 429,800 new cases of and 165,100 deaths due to bladder tumor occurred in 2012. Transurethral resection (TUR) is the gold-standard treatment for non-muscle invasive bladder cancer (NMIBC). In muscle-invasive bladder cancer, TUR also plays a vital role as a bladder-sparing procedure regardless of whether it is applied as a monotherapy or in combination with chemo-radiotherapy.

Whether radical resection of a tumor is initially performed can be essential in the treatment of bladder tumors. Incomplete TUR influences a patient's prognosis, regardless of whether it is part of a NMIBC treatment or part of bladder-sparing trimodal therapy. However, the quality of TUR is one of the greatest concerns in the treatment of bladder tumor. After initial TUR, approximately 70% of patients exhibit incomplete resection re-staging TUR. Of these patients, 30% exhibit residual tumors at the resection site. To solve this problem, a second TUR 4-6 weeks after the initial TUR is recommended by the guidelines, and these repeated TURs detect residual tumors in 26-83% of cases.

The investigators sought to identify other therapies that can be combined with TUR to eliminate residual tumors. As a minimally invasive method, cryotherapy has been widely used for urological tumors, including prostate tumor and kidney tumor. With respect to bladder tumors, cryotherapy remains in the exploration phase. Only a few studies of the use of computed tomography (CT)-guided percutaneous cryoablation for the treatment of bladder cancer have been reported. Unlike solid viscera, such as the prostate or kidney, the bladder exhibits the features of hollow viscera. Cryoablation through the transurethral approach could be possible if the safety of the procedure can be ensured. Our recent animal study conducted in a porcine model demonstrated the feasibility and safety of transurethral focal, full-thickness cryoablation. No perforations were observed during two eight-minute freeze cycles. Based on the success of transurethral cryoablation in animal experiments, the investigators performed this study to explore the safety and efficacy of cryoablation as an adjuvant therapy with TUR in the treatment of bladder tumors.

Conditions

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Urinary Bladder Neoplasms

Keywords

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Bladder Cancer Cryoablation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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TUR with Cryoablation

Patients received TUR to treat bladder cancer and immediate cryoablation was applied on the tumor bed in order to eliminate possible residual tumor. Two or three cycles of freeze could be give to fully cover the lesion. One cycle last three to five minutes base on our previous animal experiments.

Group Type EXPERIMENTAL

Cryoablation

Intervention Type PROCEDURE

Using a novel cryoablation unit to perform transurethral cryoablation on the tumor base after transurethral resection

TUR with instant instillation

Patients received TUR to treat bladder cancer and pirarubicin instillation was given within 24 hours after TUR. This is in accord with the current guideline.

Group Type ACTIVE_COMPARATOR

Epirubicin

Intervention Type DRUG

Epirubicin instillation should be give within 24 hours after initial TUR, this is accord with current guideline.

Interventions

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Cryoablation

Using a novel cryoablation unit to perform transurethral cryoablation on the tumor base after transurethral resection

Intervention Type PROCEDURE

Epirubicin

Epirubicin instillation should be give within 24 hours after initial TUR, this is accord with current guideline.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Clinically diagnosed bladder tumor, stage T1 or T2
* Number of lesions ≤ 3
* Tumor size ≤ 3cm

Exclusion Criteria

* With other malignant diseases
* T3 or above
* Enlarged pelvic lymph node or distant metastasis
* Poor overall condition
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University

OTHER

Sponsor Role collaborator

Shanghai Zhongshan Hospital

OTHER

Sponsor Role collaborator

Shanghai 5th People's Hospital

OTHER

Sponsor Role collaborator

Zhejiang Provincial People's Hospital

OTHER

Sponsor Role collaborator

Huashan Hospital

OTHER

Sponsor Role lead

Responsible Party

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Haowen Jiang

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Haowen Jiang, Doctor

Role: STUDY_DIRECTOR

Huashan Hospital

Central Contacts

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Shenghua Liu, Doctor

Role: CONTACT

Phone: +86 021 52889999

Email: [email protected]

References

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Liu S, Zou L, Mao S, Zhang L, Xu H, Yang T, Jiang H, Ding Q. The safety and efficacy of bladder cryoablation in a beagle model by using a novel balloon cryoprobe. Cryobiology. 2016 Apr;72(2):157-60. doi: 10.1016/j.cryobiol.2016.02.007. Epub 2016 Mar 3.

Reference Type BACKGROUND
PMID: 26939677 (View on PubMed)

Hruby GW, Marruffo F, Ortiz J, Durak E, Edelstein A, Levi G, Landman J. Transurethral bladder cryoablation in the porcine model. Urology. 2007 Aug;70(2):391-5. doi: 10.1016/j.urology.2007.03.028.

Reference Type BACKGROUND
PMID: 17826526 (View on PubMed)

Xu C, Jiang S, Zou L, Sheng L, Shi G, Xu B, Wang Z, Xu D, Xie X, Luo J, Guo J, Jiang H. Endoscopic balloon cryoablation plus transurethral resection for bladder cancer: A phase 2, multicenter, randomized, controlled trial. Cancer. 2023 Feb 1;129(3):415-425. doi: 10.1002/cncr.34563. Epub 2022 Dec 7.

Reference Type DERIVED
PMID: 36477612 (View on PubMed)

Other Identifiers

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SENSCURE-2015-BCC

Identifier Type: -

Identifier Source: org_study_id