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Conventional or Video-Assisted Surgery in Treating Patients With Lung Metastases

Phase 3
Completed
Conditions
Metastatic Cancer
Interventions
Procedure: surgical procedure
Registration Number
NCT00003724
Lead Sponsor
Alliance for Clinical Trials in Oncology
Brief Summary

RATIONALE: Video-assisted surgery may have fewer side effects than conventional surgery in patients with lung metastases. It is not yet known whether conventional surgery or video-assisted surgery is more effective in treating lung metastases.

PURPOSE: Randomized phase III trial to compare the effectiveness of conventional surgery with that of video-assisted surgery in treating patients who have lung metastases.

Detailed Description

OBJECTIVES: I. Compare the overall survival and failure free survival of patients with isolated pulmonary metastases treated with minimally invasive (video assisted) resection or open resection. II. Compare patterns of recurrence in these patients after these treatments, and determine what factors are predictive of recurrence. III. Describe and compare the complications and morbidity associated with minimally-invasive and open approaches to metastasectomy in these patients. IV. Test whether the patients undergoing video-assisted thoracic surgery will have a significantly better quality of life over a six month period than those undergoing an open resection.

OUTLINE: This is a randomized study. Patients are stratified according to histology (sarcoma vs epithelial vs germ cell vs melanoma) and disease laterality. After spiral CT showing pulmonary nodules are amenable to video-assisted thoracic surgery (VATS) resection with curative intent, patients are randomized to undergo either open resection (thoracotomy, median sternotomy, or bilateral sternothoracotomy) (arm I) or minimally-invasive video-assisted resection (arm II). Patients with isolated recurrence in the chest should have the recurrence(s) resected if feasible. The original resection approach (open versus VATS) should be the preferred method for the second resection, but is not required. Quality of life is assessed prior to randomization and then at 30 days, 3 months, and 6 months. Patients are followed every 3 months for 1 year and then every 6 months thereafter.

PROJECTED ACCRUAL: There will be 530 patients accrued into this study in approximately 3 years.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
530
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
surgerysurgical procedurePatients undergo open resection (thoracotomy, median sternotomy, or bilateral sternothoracotomy). Patients with isolated recurrence in the chest should have the recurrence(s) resected if feasible. The original resection approach (open versus VATS) should be the preferred method for the second resection, but is not required. Quality of life is assessed prior to randomization and then at 30 days, 3 months, and 6 months. Patients are followed every 3 months for 1 year and then every 6 months thereafter.
video-assisted surgerysurgical procedureAfter spiral CT showing pulmonary nodules are amenable to video-assisted thoracic surgery (VATS) resection with curative intent, patients undergo minimally-invasive video-assisted resection. Patients with isolated recurrence in the chest should have the recurrence(s) resected if feasible. The original resection approach (open versus VATS) should be the preferred method for the second resection, but is not required. Quality of life is assessed prior to randomization and then at 30 days, 3 months, and 6 months. Patients are followed every 3 months for 1 year and then every 6 months thereafter.
Primary Outcome Measures
NameTimeMethod
overall survivalUp to 5 years
Secondary Outcome Measures
NameTimeMethod
recurrence free survivalUp to 5 years

Trial Locations

Locations (45)

University of Massachusetts Memorial Medical Center

🇺🇸

Worcester, Massachusetts, United States

Veterans Affairs Medical Center - Columbia (Truman Memorial)

🇺🇸

Columbia, Missouri, United States

Veterans Affairs Medical Center - Togus

🇺🇸

Togus, Maine, United States

Walter Reed Army Medical Center

🇺🇸

Washington, District of Columbia, United States

Barnes-Jewish Hospital

🇺🇸

Saint Louis, Missouri, United States

University of Iowa Hospitals and Clinics

🇺🇸

Iowa City, Iowa, United States

University of California San Diego Cancer Center

🇺🇸

La Jolla, California, United States

Lombardi Cancer Center, Georgetown University

🇺🇸

Washington, District of Columbia, United States

Veterans Affairs Medical Center - Memphis

🇺🇸

Memphis, Tennessee, United States

New York Presbyterian Hospital - Cornell Campus

🇺🇸

New York, New York, United States

Norris Cotton Cancer Center

🇺🇸

Lebanon, New Hampshire, United States

University of Illinois at Chicago Health Sciences Center

🇺🇸

Chicago, Illinois, United States

Veterans Affairs Medical Center - Chicago (Westside Hospital)

🇺🇸

Chicago, Illinois, United States

University of Chicago Cancer Research Center

🇺🇸

Chicago, Illinois, United States

Ellis Fischel Cancer Center - Columbia

🇺🇸

Columbia, Missouri, United States

University of Missouri

🇺🇸

Columbia, Missouri, United States

CCOP - North Shore University Hospital

🇺🇸

Manhasset, New York, United States

CCOP - Syracuse Hematology-Oncology Associates of Central New York, P.C.

🇺🇸

Syracuse, New York, United States

State University of New York - Upstate Medical University

🇺🇸

Syracuse, New York, United States

Veterans Affairs Medical Center - Syracuse

🇺🇸

Syracuse, New York, United States

CCOP - Christiana Care Health Services

🇺🇸

Wilmington, Delaware, United States

CCOP - Mount Sinai Medical Center

🇺🇸

Miami Beach, Florida, United States

Marlene & Stewart Greenebaum Cancer Center, University of Maryland

🇺🇸

Baltimore, Maryland, United States

Dana-Farber Cancer Institute

🇺🇸

Boston, Massachusetts, United States

Veterans Affairs Medical Center - Buffalo

🇺🇸

Buffalo, New York, United States

North Shore University Hospital

🇺🇸

Manhasset, New York, United States

Mount Sinai Medical Center, NY

🇺🇸

New York, New York, United States

Arthur G. James Cancer Hospital - Ohio State University

🇺🇸

Columbus, Ohio, United States

University of Tennessee, Memphis Cancer Center

🇺🇸

Memphis, Tennessee, United States

UCSF Cancer Center and Cancer Research Institute

🇺🇸

San Francisco, California, United States

Veterans Affairs Medical Center - San Francisco

🇺🇸

San Francisco, California, United States

Veterans Affairs Medical Center - Minneapolis

🇺🇸

Minneapolis, Minnesota, United States

University of Nebraska Medical Center

🇺🇸

Omaha, Nebraska, United States

CCOP - Southern Nevada Cancer Research Foundation

🇺🇸

Las Vegas, Nevada, United States

Veterans Affairs Medical Center - Durham

🇺🇸

Durham, North Carolina, United States

Duke Comprehensive Cancer Center

🇺🇸

Durham, North Carolina, United States

Memorial Sloan-Kettering Cancer Center

🇺🇸

New York, New York, United States

Veterans Affairs Medical Center - White River Junction

🇺🇸

White River Junction, Vermont, United States

Lineberger Comprehensive Cancer Center, UNC

🇺🇸

Chapel Hill, North Carolina, United States

CCOP - Southeast Cancer Control Consortium

🇺🇸

Winston-Salem, North Carolina, United States

Comprehensive Cancer Center of Wake Forest University Baptist Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Veterans Affairs Medical Center - Richmond

🇺🇸

Richmond, Virginia, United States

MBCCOP - Massey Cancer Center

🇺🇸

Richmond, Virginia, United States

Rhode Island Hospital

🇺🇸

Providence, Rhode Island, United States

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