Protocol of the Italian Radical Cystectomy Registry
- Conditions
- Bladder Cancer
- Interventions
- Procedure: Radical cystectomy
- Registration Number
- NCT04228198
- Lead Sponsor
- University of Roma La Sapienza
- Brief Summary
Background: Bladder cancer is the ninth most common type of cancer worldwide. In the past, Radical Cystectomy via open surgery has been considered the gold-standard treatment for muscle invasive bladder cancer. However, in recent years there has been a progressive increase in the use of robot-assisted laparoscopic radical cystectomy surgery. The aim of the current project is to investigate the surgical, oncological, and functional outcomes of patients with bladder cancer who undergo radical cystectomy surgery comparing three different surgical techniques (robotic-assisted, laparoscopic, and open surgery). Pre-, peri- and post-operative factors will be examined, and participants will be followed for a period of up to 24 months to identify risks of mortality, oncological outcomes, hospital readmission, sexual performance, and continence.
Methods: The study is an observational, prospective, multicenter, cohort study to assess patients affected by bladder neoplasms undergoing radical cystectomy and urinary diversion. The Italian Radical Cystectomy Registry is an electronic registry to prospectively collect the data of patients undergoing Radical Cystectomy conducted with any technique (open, laparoscopic, robotic-assisted). Twenty-eight urology departments across Italy will provide data for the study, with recruitment phase between 1st January 2017-31st June 2020). Information is collected from the patients at the moment of surgical intervention and during follow-up (3, 6, 12, and 24 months after radical cystectomy surgery). Peri-operative variables include surgery time, type of urinary diversion, conversion to open surgery, bleeding, nerves sparing and lymphadenectomy. Follow-up data collection includes histological information (e.g., post-op staging, grading and tumor histology), short- and long-term outcomes (e.g., mortality, post-op complications, hospital readmission, sexual potency, continence etc).
Discussion: The current protocol aims to contribute additional data to the field concerning the short- and long-term outcomes of three different radical cystectomy surgical techniques for patients with bladder cancer, including open, laparoscopic, and robot-assisted. This is a comparative-effectiveness trial that takes into account a complex range of factors and decision making by both physicians and patients that affect their choice of surgical technique.
- Detailed Description
The aim of the project is to investigate the surgical, oncological, and functional outcomes of patients with bladder cancer who undergo radical cystectomy surgery comparing three different surgical techniques (robotic-assisted, laparoscopic, and open surgery). Pre-, peri- and post-operative factors will be examined, and participants will be followed for a period of up to 24 months to identify risks of mortality, oncological outcomes, hospital readmission, sexual performance, and continence.
Twenty-eight participating centers across Italy will provide data for the study: Urology Clinic, University of Bologna; Department of Urology, AOU Careggi, Florence; European Institute of Oncology Milan; San Raffaele Hospital, Milan; University Hospital of Verona; Department of Urology, Policlinico Abano; Department of Urology, Spedali Civili, Brescia; Department of Urology and Kidney Transplantation, University of Foggia, Foggia; Galliera Hospital, Genova; ASST Niguarda Metropolitan Hospital, Niguarda; Policlinico Umberto I, Saproma; Department of Clinical Urology, University of Perugia; Department of Clinical Urology, AOUP Cisanello Hospital, Pisa; Department of Clinical Urology, Palermo University, Palermo; Department of Clinical Urology, Alessandria Hospital, Alessandria; Department of Clinical Urology, ASST Mantova, Mantova; Department of Clinical Urology, ASL Abruzzo; Department of Clinical Urology Ca Foncello Hospital, Treviso; Department of Clinical Urology II, Bari University, Bari; Department of Clinical Urology, Vittorio Emanuele Hospital, Catania; Department of Clinical Urology, Casa Sollievo della Sofferenza, Sgrotondo; Hospital Bassiano, Bassano; Department of Clinical Urology, Hospital San Francesco ASL 3, Nuoro; Department of Clinical Urology, Portogruaro; Department of Clinical Urology, Biella Hospital, Biella; Department of Clinical Urology Chioggia Hospital; Ausl Modena; Department of Urology and Kidney Transplantation, Bianchi-Melacrino-Morelli Grand Metropolitan Hospital.
The inclusion criteria are: 1) male and female consecutively recruited patients; 2) age ≥18 years; 3) histologically confirmed diagnosis of bladder cancer eligible for radical cystectomy surgery at date of enrollment; 4) providing written, informed consent.
At baseline and after 3, 6, 12, and 24 months post-surgery, data will be taken directly from the patients at their follow-up medical visits and entered into the online database. The physician identifying and recruiting patients is in charge of completing the data collection forms during follow-up, even if the patient is subsequently treated in another center.
Variables of interest include demographic variables (age, sex, etc), surgical factors (technique use, length of surgery, blood loss, type of urinary diversion, node burden, histological exams, surgical margins etc), mortality, morbidity (pre-, during- and post-surgery), oncological results, and functioning (continence and sexual performance) over follow-up.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 1000
- Male and female consecutively recruited patients
- Age ≥18 years
- Histologically confirmed diagnosis of bladder cancer eligible for radical cystectomy surgery (according to EAU guidelines) at date of enrollment
- Providing written, informed consent
Not provided
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Radical cystectomy Radical cystectomy Patients with histologically confirmed diagnosis of bladder cancer undergoing radical cystectomy surgery at 28 Urology departments in Italy
- Primary Outcome Measures
Name Time Method Eventual conversion to open surgery Baseline If the surgery technique changes from laproscopic surgery to open surgery during the intervention at baseline
Number of participants who underwent nerve-sparing Baseline Nerve sparing during baseline surgery (no/unilateral/bilateral)
Type of urinary diversion Baseline Type of urinary diversion performed during the cystectomy surgery at baseline
Amount of surgical blood loss Baseline Amount of blood lost during the surgical procedure at baseline in milliliters
Number of participants who underwent lymphadenectomy Baseline lymphadenectomy (not performed/ bilateral external iliac nodes /bilateral presacral iliac) during baseline surgery
Surgery time Baseline Total surgery time, in minutes during surgery at baseline
- Secondary Outcome Measures
Name Time Method Histological evaluation of all patients Immediately after surgery Tumor histology, (transitional cell carcinoma, adenocarcinoma, or other)
Sexual potency rates Up to 24 months Sexual potency in the patient following surgery. Self-reported.
Rate of Hospitalization Up to 24 months Any in-patient hospitalization in teh 24 months following surgical discharge.
Rate of Mortality Up to 24 months All-cause mortality after surgery
Continence rates Up to 24 months Daytime and nighttime continence following surgery.
Trial Locations
- Locations (1)
policlinico Umberto I - Department of Gynecological-Obstetrics Sciences and Urological Sciences
🇮🇹Roma, Italy