The Difference of Two Year Recurrence Rate According to Anesthetic Method During Transurethral Resection of Bladder Mass in Patients With Non-muscle Invasive Bladder Cancer: Prospective, Randomized, Clinical Phase II Study

NCT ID: NCT03597087

Last Updated: 2018-07-24

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

289 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-07-19

Study Completion Date

2022-12-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The investigators compare the recurrence rate difference between two years after transurethral resection of the bladder tumor according to the method of anesthesia. Anesthetic methods are general anesthesia and spinal anesthesia. Assessment of recurrence is assessed by bladder endoscopy, CT, and pathological examination of surgical specimens.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

1. Research Background Most of the bladder cancer (approximately 85%) has histologic features of urothelial carcinoma. Approximately 75% of the patients initially diagnosed as non-invasive bladder cancer (stage I, CIS) or submucosal stage T1 -muscle invasive bladder cancer - NMIBC). However, it has been reported that about 60% to 70% of patients experience recurrence and 20% to 30% of relapsed cancers require radical cystectomy or chemotherapy It is known to progress to high-grade or high grade cancer.

There are studies that involve surgical factors such as volatile anesthetics, narcotic analgesics, anti-body temperature, blood transfusion, and cancer recurrence. Minimizing the use of volatile anesthetics and narcotic analgesics reduces spinal anesthesia before and after surgery, It has been reported that there is a correlation with maintenance of immune cell function
2. Research hypothesis and purpose The aim of this study was to evaluate the recurrence rate, recurrence - free survival rate, and recurrence - free survival rate of non - muscle invasive bladder carcinoma in patients undergoing bladder resection.
3. Research Method

* Preoperative screening: Physical examination, Blood test, CT urography, Urine analysis, Urine culture, Urine cytology, Cystoscopy. Enforced
* Randomization on the day before surgery: 289 patients were randomly assigned to a spinal anesthesia group and a general anesthesia group 1: 1.

Urine analysis, urine culture, urine cytology, and cystoscopy were performed every 3 months up to 2 years postoperatively. CT urography performed once a year

* Follow-up procedure: Follow-up procedure according to bladder cancer standard.

4\. Observation items, clinical examination items and observational examination methods
* Screening: CT urography, Urine analysis, Urine culture, Urine cytology, Cystoscopy. Observe
* Follow up: Urine analysis, Urine culture, Urine cytology, Cystoscopy every 3 months after the operation, CT urography every year

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Bladder Cancer

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

After randomization, they were divided into two parallel groups 289 patients were randomly assigned to a spinal anesthesia group and a general anesthesia group 1: 1.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Using a web site, and creating a randomized list at Sealedenvalop.com. Patients are randomly assigned to receive an anesthetic consent, and no masking is performed.

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

General anesthesia

Group of general anesthesia before transurethral resection of the bladder tumor anesthesia: propopol

Group Type EXPERIMENTAL

Anesthesia before transurethral resection of the bladder tumor

Intervention Type PROCEDURE

General anaesthesia or general anesthesia (see spelling differences) is a medically induced coma with loss of protective reflexes, resulting from the administration of one or more general anaesthetic agents.

Spinal anaesthesia is a form of regional anaesthesia involving the injection of a local anaesthetic into the subarachnoid space, generally through a fine needle

Anesthesia

Intervention Type DRUG

General anaesthesia : propopol

Spinal anaesthesia : bupibacaine

Spinal anesthesia

Group of spinal anesthesia before transurethral resection of the bladder tumor anesthesia: bupibacaine

Group Type EXPERIMENTAL

Anesthesia before transurethral resection of the bladder tumor

Intervention Type PROCEDURE

General anaesthesia or general anesthesia (see spelling differences) is a medically induced coma with loss of protective reflexes, resulting from the administration of one or more general anaesthetic agents.

Spinal anaesthesia is a form of regional anaesthesia involving the injection of a local anaesthetic into the subarachnoid space, generally through a fine needle

Anesthesia

Intervention Type DRUG

General anaesthesia : propopol

Spinal anaesthesia : bupibacaine

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Anesthesia before transurethral resection of the bladder tumor

General anaesthesia or general anesthesia (see spelling differences) is a medically induced coma with loss of protective reflexes, resulting from the administration of one or more general anaesthetic agents.

Spinal anaesthesia is a form of regional anaesthesia involving the injection of a local anaesthetic into the subarachnoid space, generally through a fine needle

Intervention Type PROCEDURE

Anesthesia

General anaesthesia : propopol

Spinal anaesthesia : bupibacaine

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

1. 18 years old or older
2. Patients with suspected Ta / T1 non-muscle invasive bladder cancer
3. Patients who were not previously treated with other cancers
4. Normal range creatinine, AST, ALT patients
5. Patients with both spinal anesthesia and general anesthesia

Exclusion Criteria

1. Patients with urinary tract carcinoma not invading the renal pelvis, ureter or urethra
2. Patients with cancer other than bladder cancer or a history of treatment
3. Patients with clinical evidence of muscle-invasive bladder cancer
4. Patients taking immunosuppressive drugs and immunosuppressive drugs
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Seoul National University Hospital

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Ja Hyeon Ku

Professor, MD., PHD.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Jin Tae Kim, PhD

Role: STUDY_DIRECTOR

Professor, Department of Anesthesiology, Seoul National University Hospital

Ja Hyeon Ku, PhD

Role: STUDY_CHAIR

Professor, Department of Urology, Seoul National University Hospital

Hyeong Dong Yuk, MD

Role: PRINCIPAL_INVESTIGATOR

Clinical fellow, Department of Urology, Seoul National University Hospital

Song Hee Kim, Bacheolor

Role: PRINCIPAL_INVESTIGATOR

Researcher, Department of Urology, Seoul National University Hospital

Jae Hyun Jung, MD

Role: PRINCIPAL_INVESTIGATOR

Clinical fellow, Department of Urology, Seoul National University Hospital

Jung Hoon Lee, MD

Role: PRINCIPAL_INVESTIGATOR

Clinical fellow, Department of Urology, Seoul National University Hospital

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Seoul National University Hospital

Seoul, , South Korea

Site Status

Countries

Review the countries where the study has at least one active or historical site.

South Korea

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Hyeong Dong Yuk, MD

Role: CONTACT

+82-2-2072-1968

Song Hee Kim, Bacheolo

Role: CONTACT

+82-2-2072-1968

References

Explore related publications, articles, or registry entries linked to this study.

Herr HW, Faulkner JR, Grossman HB, Natale RB, deVere White R, Sarosdy MF, Crawford ED. Surgical factors influence bladder cancer outcomes: a cooperative group report. J Clin Oncol. 2004 Jul 15;22(14):2781-9. doi: 10.1200/JCO.2004.11.024. Epub 2004 Jun 15.

Reference Type RESULT
PMID: 15199091 (View on PubMed)

Christodouleas JP, Baumann BC, He J, Hwang WT, Tucker KN, Bekelman JE, Tangen CM, Lerner SP, Guzzo TJ, Malkowicz SB, Herr H. Optimizing bladder cancer locoregional failure risk stratification after radical cystectomy using SWOG 8710. Cancer. 2014 Apr 15;120(8):1272-80. doi: 10.1002/cncr.28544. Epub 2014 Jan 3.

Reference Type RESULT
PMID: 24390799 (View on PubMed)

Witjes JA, Comperat E, Cowan NC, De Santis M, Gakis G, Lebret T, Ribal MJ, Van der Heijden AG, Sherif A; European Association of Urology. EAU guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2013 guidelines. Eur Urol. 2014 Apr;65(4):778-92. doi: 10.1016/j.eururo.2013.11.046. Epub 2013 Dec 12.

Reference Type RESULT
PMID: 24373477 (View on PubMed)

Pollack A, Zagars GK, Cole CJ, Dinney CP, Swanson DA, Grossman HB. The relationship of local control to distant metastasis in muscle invasive bladder cancer. J Urol. 1995 Dec;154(6):2059-63; discussion 2063-4.

Reference Type RESULT
PMID: 7500458 (View on PubMed)

Jensen JB, Ulhoi BP, Jensen KM. Extended versus limited lymph node dissection in radical cystectomy: impact on recurrence pattern and survival. Int J Urol. 2012 Jan;19(1):39-47. doi: 10.1111/j.1442-2042.2011.02887.x. Epub 2011 Nov 3.

Reference Type RESULT
PMID: 22050425 (View on PubMed)

Zaghloul MS, Awwad HK, Akoush HH, Omar S, Soliman O, el Attar I. Postoperative radiotherapy of carcinoma in bilharzial bladder: improved disease free survival through improving local control. Int J Radiat Oncol Biol Phys. 1992;23(3):511-7. doi: 10.1016/0360-3016(92)90005-3.

Reference Type RESULT
PMID: 1612951 (View on PubMed)

Lawton CA, Michalski J, El-Naqa I, Buyyounouski MK, Lee WR, Menard C, O'Meara E, Rosenthal SA, Ritter M, Seider M. RTOG GU Radiation oncology specialists reach consensus on pelvic lymph node volumes for high-risk prostate cancer. Int J Radiat Oncol Biol Phys. 2009 Jun 1;74(2):383-7. doi: 10.1016/j.ijrobp.2008.08.002. Epub 2008 Oct 22.

Reference Type RESULT
PMID: 18947938 (View on PubMed)

Baumann BC, Guzzo TJ, He J, Keefe SM, Tucker K, Bekelman JE, Hwang WT, Vaughn DJ, Malkowicz SB, Christodouleas JP. A novel risk stratification to predict local-regional failures in urothelial carcinoma of the bladder after radical cystectomy. Int J Radiat Oncol Biol Phys. 2013 Jan 1;85(1):81-8. doi: 10.1016/j.ijrobp.2012.03.007. Epub 2012 Apr 28.

Reference Type RESULT
PMID: 22543204 (View on PubMed)

Baumann BC, Guzzo TJ, He J, Vaughn DJ, Keefe SM, Vapiwala N, Deville C, Bekelman JE, Tucker K, Hwang WT, Malkowicz SB, Christodouleas JP. Bladder cancer patterns of pelvic failure: implications for adjuvant radiation therapy. Int J Radiat Oncol Biol Phys. 2013 Feb 1;85(2):363-9. doi: 10.1016/j.ijrobp.2012.03.061. Epub 2012 May 30.

Reference Type RESULT
PMID: 22658217 (View on PubMed)

Ku JH, Kim M, Jeong CW, Kwak C, Kim HH. Risk prediction models of locoregional failure after radical cystectomy for urothelial carcinoma: external validation in a cohort of korean patients. Int J Radiat Oncol Biol Phys. 2014 Aug 1;89(5):1032-1037. doi: 10.1016/j.ijrobp.2014.04.049. Epub 2014 Jul 8.

Reference Type RESULT
PMID: 25035206 (View on PubMed)

Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015 Mar 1;136(5):E359-86. doi: 10.1002/ijc.29210. Epub 2014 Oct 9.

Reference Type RESULT
PMID: 25220842 (View on PubMed)

Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015 Mar;65(2):87-108. doi: 10.3322/caac.21262. Epub 2015 Feb 4.

Reference Type RESULT
PMID: 25651787 (View on PubMed)

Babjuk M, Burger M, Comperat E, Palou J, Roupret M, van Rhijn B, Shariat S, Sylvester R, Zigeuner R, Gontero P, Mostafid H. Reply to Harry Herr's Letter to the Editor re: Marko Babjuk, Andreas Bohle, Maximilian Burger, et al. EAU Guidelines on Non-muscle-invasive Urothelial Carcinoma of the Bladder: Update 2016. Eur Urol 2017;71:447-61. Eur Urol. 2017 Jun;71(6):e173-e174. doi: 10.1016/j.eururo.2016.11.029. Epub 2016 Dec 7. No abstract available.

Reference Type RESULT
PMID: 27939074 (View on PubMed)

Burger M, Catto JW, Dalbagni G, Grossman HB, Herr H, Karakiewicz P, Kassouf W, Kiemeney LA, La Vecchia C, Shariat S, Lotan Y. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol. 2013 Feb;63(2):234-41. doi: 10.1016/j.eururo.2012.07.033. Epub 2012 Jul 25.

Reference Type RESULT
PMID: 22877502 (View on PubMed)

Kamat AM, Witjes JA, Brausi M, Soloway M, Lamm D, Persad R, Buckley R, Bohle A, Colombel M, Palou J. Defining and treating the spectrum of intermediate risk nonmuscle invasive bladder cancer. J Urol. 2014 Aug;192(2):305-15. doi: 10.1016/j.juro.2014.02.2573. Epub 2014 Mar 25.

Reference Type RESULT
PMID: 24681333 (View on PubMed)

Hall MC, Chang SS, Dalbagni G, Pruthi RS, Seigne JD, Skinner EC, Wolf JS Jr, Schellhammer PF. Guideline for the management of nonmuscle invasive bladder cancer (stages Ta, T1, and Tis): 2007 update. J Urol. 2007 Dec;178(6):2314-30. doi: 10.1016/j.juro.2007.09.003. No abstract available.

Reference Type RESULT
PMID: 17993339 (View on PubMed)

Morales A, Eidinger D, Bruce AW. Intracavitary Bacillus Calmette-Guerin in the treatment of superficial bladder tumors. J Urol. 1976 Aug;116(2):180-3. doi: 10.1016/s0022-5347(17)58737-6.

Reference Type RESULT
PMID: 820877 (View on PubMed)

Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001 Feb 17;357(9255):539-45. doi: 10.1016/S0140-6736(00)04046-0.

Reference Type RESULT
PMID: 11229684 (View on PubMed)

Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010 Mar 19;140(6):883-99. doi: 10.1016/j.cell.2010.01.025.

Reference Type RESULT
PMID: 20303878 (View on PubMed)

Kim HS, Ku JH. Systemic Inflammatory Response Based on Neutrophil-to-Lymphocyte Ratio as a Prognostic Marker in Bladder Cancer. Dis Markers. 2016;2016:8345286. doi: 10.1155/2016/8345286. Epub 2016 Jan 5.

Reference Type RESULT
PMID: 26880857 (View on PubMed)

Crumley AB, McMillan DC, McKernan M, Going JJ, Shearer CJ, Stuart RC. An elevated C-reactive protein concentration, prior to surgery, predicts poor cancer-specific survival in patients undergoing resection for gastro-oesophageal cancer. Br J Cancer. 2006 Jun 5;94(11):1568-71. doi: 10.1038/sj.bjc.6603150.

Reference Type RESULT
PMID: 16685271 (View on PubMed)

Dutta S, Crumley AB, Fullarton GM, Horgan PG, McMillan DC. Comparison of the prognostic value of tumour and patient related factors in patients undergoing potentially curative resection of gastric cancer. Am J Surg. 2012 Sep;204(3):294-9. doi: 10.1016/j.amjsurg.2011.10.015. Epub 2012 Mar 22.

Reference Type RESULT
PMID: 22444831 (View on PubMed)

Kweon TD, Lee KY. Spinal anesthesia is associated with lower recurrence rates after resection of non-muscle invasive bladder cancer. Transl Androl Urol. 2018 Apr;7(2):283-286. doi: 10.21037/tau.2018.03.13. No abstract available.

Reference Type RESULT
PMID: 29733090 (View on PubMed)

Han JH, Yuk HD, Jeong SH, Jeong CW, Kwak C, Kim JT, Ku JH. Anesthetic approaches and 2-year recurrence rates in non-muscle invasive bladder cancer: a randomized clinical trial. Reg Anesth Pain Med. 2024 Dec 31:rapm-2024-105949. doi: 10.1136/rapm-2024-105949. Online ahead of print.

Reference Type DERIVED
PMID: 39740955 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

SeoulNUH_2018_TURBT

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.