Anesthesia Modality and Oncologic Outcomes in High-Risk NMIBC: A Randomized Trial

NCT ID: NCT06982690

Last Updated: 2025-05-21

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

370 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-08-01

Study Completion Date

2029-11-30

Brief Summary

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To demonstrate the superior efficacy of spinal anesthesia (SA) versus general anesthesia (GA) according to the delay of time to recurrence in high-risk NMIBC patients up to Week 104 after TURBT.

Detailed Description

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Conditions

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NMIBC TURBT Bladder (Urothelial, Transitional Cell) Cancer Bladder Cancer Recurrence Anesthesia, General Anesthesia,Spinal

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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General Anesthesia

Group Type PLACEBO_COMPARATOR

General Anesthesia

Intervention Type PROCEDURE

Induction will be performed with propofol (0.5-1.5 mg/kg) and fentanyl (1-2 µg/kg), and anesthesia will be maintained with sevoflurane (1-3 vol %) via a laryngeal mask or endotracheal intubation. Rocuronium (0.5-0.6 mg/kg) will be used for induction, maintenance and occurrence of obturator jerk.

Spinal Anesthesia

Group Type ACTIVE_COMPARATOR

Spinal Anesthesia

Intervention Type PROCEDURE

A total of 10-12 mg of 0.5% bupivacaine will be administered into the cerebrospinal fluid of the subarachnoid space using a 25-gauge Quincke spinal needle via an 18-gauge introducer (adjusted by body height). Midazolam (2-5 mg) may be used to decrease anxiety.

Interventions

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Spinal Anesthesia

A total of 10-12 mg of 0.5% bupivacaine will be administered into the cerebrospinal fluid of the subarachnoid space using a 25-gauge Quincke spinal needle via an 18-gauge introducer (adjusted by body height). Midazolam (2-5 mg) may be used to decrease anxiety.

Intervention Type PROCEDURE

General Anesthesia

Induction will be performed with propofol (0.5-1.5 mg/kg) and fentanyl (1-2 µg/kg), and anesthesia will be maintained with sevoflurane (1-3 vol %) via a laryngeal mask or endotracheal intubation. Rocuronium (0.5-0.6 mg/kg) will be used for induction, maintenance and occurrence of obturator jerk.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Age ≥40 years for male subjects or postmenopausal female subjects
* ECOG performance status 0-2
* Patients with suspected or newly diagnosed UBUC
* ASA I or II
* Patients with any other adequately treated Stage I or II cancer except UC, from which the subject has been disease free for 5 years
* Adequate renal function, defined as a serum creatinine (Cre) concentration ≤ the institutional ULN
* Adequate hepatic function, defined as total bilirubin ≤ the institutional ULN and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ the institutional upper limit of normal (ULN)

Exclusion Criteria

* Patients with prior or concurrent UC involving the renal pelvis, ureter or urethra
* Patients with clinical evidence of MIBC or mUC
* Immunocompromised or immunosuppressed patients
* Patients with chronic use of anti-inflammatory agents or beta-blockers
* Patients with difficult airways or other significant cardiovascular comorbidities (severe aortic stenosis, significant pulmonary disease, CHF) who are intolerant to GA
* Patients with elevated intracranial pressure (ICP), primarily due to intracranial mass and trauma or infection at the site of SA
* Patients with a serious uncontrolled medical disorder (e.g., trauma, fracture) or active infection that would impair their ability to receive spinal or GA
* Patients with known allergies to propofol, fentanyl, sevoflurane, or bupivacaine
* Subjects with a known history or family history of malignant hyperthermia
* Subjects with bleeding diathesis
Minimum Eligible Age

20 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Taiwan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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National Taiwan University Clinical Trial Center

Director, Department of Urology at National Taiwan University Hospital

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Department of Urology, College of Medicine, National Taiwan University

Taipei, Taipei, Taiwan

Site Status

Countries

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Taiwan

Central Contacts

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Jeff Shih-Chieh Chueh, MD, PhD

Role: CONTACT

+886-2312-3456 ext. 262135

Chu-Wen Fang, MD, MMed

Role: CONTACT

+886-2312-3456 ext. 265728

Other Identifiers

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202411115RINE

Identifier Type: -

Identifier Source: org_study_id

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