Bladder CancerNCT06253091
Comparison of the Application of Robot-assisted Laparoscopic Pathways in Radical Cystectomy
A study testing robit-assist extraperitoneal laparoscopic radical cystectomy in people with Bladder Cancer, run by The First Affiliated Hospital with Nanjing Medical University at 1 site in China.
Trial summary
Traditional radical cystectomy (RC) is performed transabdominal. However, it often has high postoperative complications. There have been studies on extraperitoneal approach to reduce postoperative complications. Investigators divided participants underwent robot-assisted radical cystectomy into two groups (1:1) . Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Bladder Cancer
- What is being tested?
- robit-assist extraperitoneal laparoscopic radical cystectomy
- Type of treatment
- Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 50 participants
- Where
- 1 siteChina
- Study dates
- 1 Feb 2024to 30 Dec 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Researchers evaluated patients with muscle invasive bladder cancer or high-risk non-muscular invasive bladder cancer who needed radical cystectomy.
- Willing to accept the operation and meet the surgical index: a) Absolute count of neutrophils≥1.5x109/L; b) Platelets≥100×109/L; c) Hemoglobin≥90g/L; d) International standardized ratio or activationPartial thrombin time≤1.5 Upper limit of normal value (ULN); e) calculated creatinine clearance rate≥1 ml/s; f) Total serum bilirubin≤1.5×ULN; g) AST, ALT and alkaline phosphatase≤2.5×ULN; h) Cardiopulmonary function indicates that it can tolerate major abdominal surgery;
- None of the pastHistory of abdominal surgery;
- 18 to 75 years old;
- ECOG physical state 0 or 1;
- voluntarily participate in this experiment, be able to provide a written version of the informed consent, and be able to understand and agree to comply with the requirements of this study and the evaluation schedule;
Who cannot join
- Patients who refuse to receive radical cystectomy
- Researchers evaluate patients who are unable to tolerate radical cystectomy;
- There is a abdominal history of surgery;
- Have had a large-scale operation or major trauma within 28 days before joining the group;
- Have been vaccinated with live vaccine within 28 days before joining the group;
- Severe chronic or active infection that requires systemic anti-bacterial, antifungal or antiviral treatment within 14 days before joining the group;
- Participating in the rest of the clinical research.
Trial locations and contacts
1 site in 1 country.
China1 site, 1 recruiting
- Recruiting
The first affiliated hospital of Nanjing Medical University
Nanjing, Jiangsu, 210000
Qiang Lu, PhD, 13505196501, dxhlvqiang@163.com
Pengchao Li, PhD, 13584025756, superkulian@aliyun.com
About this study
Official title: Comparison of the Application of Robot-assisted Laparoscopic Transperitoneal and Transperitoneal Pathways in Radical Cystectomy
Traditional radical cystectomy (RC) is performed transabdominal. However, it often has high postoperative complications. There have been studies on extraperitoneal approach to reduce postoperative complications. Investigators divided participants underwent robot-assisted radical cystectomy into two groups (1:1) . One group of participants transabdominal, the other group extraperitoneal. The incidence of complications and PFS/OS at 3, and 5 years were compared.
Read the detailed description
Bladder cancer is highly prevalent worldwide and approximately 75% of these are non-muscle invasive bladder cancer (NMIBC). For high-risk NMIBC and MIBC, radical cystectomy (RC) is also the best treatment option.
The traditional transperitoneal laparoscopic radical cystectomy prolapse of abdominal organs into the pelvic cavity can lead to angulation of the intestinal tract, causing obstruction. Some studies have demonstrated that the extraperitoneal route can effectively reduce these complications Currently, robot-assisted surgery technology is widely utilized in urology. Studies have demonstrated that robot-assisted total extraperitoneal cystectomy and urinary diversion are less likely to disrupt abdominal organs, particularly the intestines. Identifying and locating membrane structures and layers with anatomical significance is crucial for navigating the correct anatomic space during the operation. The using of 3D laparoscopy or a robot-assisted extraperitoneal radical cystectomy aligns more closely with the 3D membrane anatomic concept. Furthermore, for younger patients,robot-assisted extraperitoneal radical cystectomy is more favorable for preserving reproductive function. For elderly patients, it is considered more safer.
Consequently, we aim to investigate whether robot-assisted extraperitoneal radical cystectomy is more advantageous for patients with MIBC or high-risk NMIBC.
- Conditions
- Bladder Cancer
- Being tested
- robit-assist extraperitoneal laparoscopic radical cystectomy
- Keywords
- radical cystectomy
- Medical subject headings
- Urinary Bladder Neoplasms
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
robit-assist extraperitoneal laparoscopic radical cystectomyProcedure or surgery
robit-assist laparoscopic radical cystectomy was performed extraperitoneal
| Study group | Role | What they receive |
|---|---|---|
| robit-assist transperitoneal laparoscopic radical cystectomy | No intervention | robit-assist radical cystectomy was performed transperitoneal |
| robit-assist extraperitoneal laparoscopic radical cystectomy | Experimental | robit-assist radical cystectomy was performed extraperitoneal Receives: Procedure: robit-assist extraperitoneal laparoscopic radical cystectomy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Complication rate
Complication rate after surgery
Measured: through study completion, an average of 1 month, 3 month and 1 year
Secondary outcomes (2)
OS
Overall Survival
Measured: 5 years after surgery
PFS
progression-free survival
Measured: 5 years after surgery
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted12 Feb 2024
- Study start1 Feb 2024
- Primary completion30 Oct 2024 (estimated)
- Study completion30 Dec 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (22)Papers the sponsor has linked to this study.
- Other trials for Bladder CancerStudies of the same condition, open and under way.
- More trials run by The First Affiliated Hospital with Nanjing Medical UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 50 participants (estimated)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Lv qiang, PhD, Study chair, The First Affiliated Hospital with Nanjing Medical University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06253091
- Sponsor's protocol ID
- 2023-SR-017
- Status last verified
- Feb 2024
- First submitted
- 3 Feb 2024
- Last updated
- 20 Feb 2024
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Lobo N, Afferi L, Moschini M, Mostafid H, Porten S, Psutka SP, Gupta S, Smith AB, Williams SB, Lotan Y. Epidemiology, Screening, and Prevention of Bladder Cancer. Eur Urol Oncol. 2022 Dec;5(6):628-639. doi: 10.1016/j.euo.2022.10.003. Epub 2022 Nov 1.
PubMed 36333236Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.
PubMed 33538338Knowles MA, Hurst CD. Molecular biology of bladder cancer: new insights into pathogenesis and clinical diversity. Nat Rev Cancer. 2015 Jan;15(1):25-41. doi: 10.1038/nrc3817.
PubMed 25533674Witjes JA, Bruins HM, Cathomas R, Comperat EM, Cowan NC, Gakis G, Hernandez V, Linares Espinos E, Lorch A, Neuzillet Y, Rouanne M, Thalmann GN, Veskimae E, Ribal MJ, van der Heijden AG. European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines. Eur Urol. 2021 Jan;79(1):82-104. doi: 10.1016/j.eururo.2020.03.055. Epub 2020 Apr 29.
PubMed 32360052Haeuser L, Marchese M, Noldus J, Kibel AS, Carvalho F, Preston MA, Cooper Z, Trinh QD, Mossanen M. Association between Operative Time and Short-Term Radical Cystectomy Complications. Urol Int. 2023;107(3):273-279. doi: 10.1159/000522141. Epub 2022 Mar 18.
PubMed 35306500Parra RO, Andrus CH, Jones JP, Boullier JA. Laparoscopic cystectomy: initial report on a new treatment for the retained bladder. J Urol. 1992 Oct;148(4):1140-4. doi: 10.1016/s0022-5347(17)36843-x.
PubMed 1404624Cao Q, Li P, Yang X, Qian J, Wang Z, Lu Q, Gu M. Laparoscopic radical cystectomy with pelvic re-peritonealization: the technique and initial clinical outcomes. BMC Urol. 2018 Dec 12;18(1):113. doi: 10.1186/s12894-018-0424-6.
PubMed 30541538Kulkarni JN, Gulla RI, Tongaonkar HB, Kashyapi BD, Rajyaguru KB. Radical cystoprostatectomy: an extraperitoneal retrograde approach. J Urol. 1999 Feb;161(2):545-8. doi: 10.1016/s0022-5347(01)61946-3.
PubMed 9915445Zhu YP, Ye DW, Yao XD, Zhang SL, Dai B, Shen YJ, Wang CF. Defining good candidates for extraperitoneal cystectomy: results from random peritoneum biopsies of 136 cases. Urology. 2013 Apr;81(4):820-4. doi: 10.1016/j.urology.2012.11.057. Epub 2013 Feb 20.
PubMed 23434097Park DS, Gong IH, Choi DK, Hwang JH, Kang MH, Oh JJ. A feasibility study of peritoneum preservation in radical cystectomy with extraperitonealization of orthotopic neobladder for invasive high-grade bladder cancer: a preliminary analysis. Int Urol Nephrol. 2014 Jun;46(6):1107-13. doi: 10.1007/s11255-013-0632-7. Epub 2013 Dec 20.
PubMed 24356919De Nunzio C, Cicione A, Leonardo F, Rondoni M, Franco G, Cantiani A, Tubaro A, Leonardo C. Extraperitoneal radical cystectomy and ureterocutaneostomy in octogenarians. Int Urol Nephrol. 2011 Sep;43(3):663-7. doi: 10.1007/s11255-010-9876-7. Epub 2010 Nov 26.
PubMed 21110093Jentzmik F, Schostak M, Stephan C, Baumunk D, Lingnau A, Weikert S, Lein M, Miller K, Schrader M. Extraperitoneal radical cystectomy with extraperitonealization of the ileal neobladder: a comparison to the transperitoneal technique. World J Urol. 2010 Aug;28(4):457-63. doi: 10.1007/s00345-009-0476-z. Epub 2009 Sep 24.
PubMed 19777243Feng L, Song J, Wu M, Tian Y, Zhang D. Extraperitoneal versus transperitoneal laparoscopic radical cystectomy for selected elderly bladder cancer patients: a single center experience. Int Braz J Urol. 2016 Jul-Aug;42(4):655-62. doi: 10.1590/S1677-5538.IBJU.2015.0608.
PubMed 27564274Refaai K, Sharafeldin MA, Elabbady A, Sameh W, Thurairaja R, Nair R, Dasgupta P, Khan MS, Mohamed E. Perioperative Outcomes of Open Retrograde Extraperitoneal Versus Intracorporeal Robot-assisted Radical Cystoprostatectomy in Men: A Dual-center Comparative Study. Clin Genitourin Cancer. 2020 Jun;18(3):e315-e323. doi: 10.1016/j.clgc.2019.12.006. Epub 2019 Dec 14.
PubMed 31911120Kulkarni JN, Agarwal H. Transperitoneal vs. extraperitoneal radical cystectomy for bladder cancer: A retrospective study. Int Braz J Urol. 2018 Mar-Apr;44(2):296-303. doi: 10.1590/S1677-5538.IBJU.2017.0441.
PubMed 29219280
Study at a glance
From the registry record, last updated by the sponsor on 20 Feb 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison of the Application of Robot-assisted Laparoscopic Transperitoneal and Transperitoneal Pathways in Radical Cystectomy
- ClinicalTrials.gov ID
- NCT06253091
- Acronym / sponsor ID
- 2023-SR-017
- Conditions
- Bladder Cancer
- Keywords
- radical cystectomy
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 50 participants (estimated)
- Lead sponsor
- The First Affiliated Hospital with Nanjing Medical UniversityUniversity, hospital or other
- Study start
- 1 Feb 2024 (actual)
- Primary completion
- 30 Oct 2024 (estimated)
- Study completion
- 30 Dec 2025 (estimated)
- First posted
- 12 Feb 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Traditional radical cystectomy (RC) is performed transabdominal. However, it often has high postoperative complications. There have been studies on extraperitoneal approach to reduce postoperative complications. Investigators divided participants underwent robot-assisted radical cystectomy into two groups (1:1) . One group of participants transabdominal, the other group extraperitoneal. The incidence of complications and PFS/OS at 3, and 5 years were compared.
Detailed description
Bladder cancer is highly prevalent worldwide and approximately 75% of these are non-muscle invasive bladder cancer (NMIBC). For high-risk NMIBC and MIBC, radical cystectomy (RC) is also the best treatment option.
The traditional transperitoneal laparoscopic radical cystectomy prolapse of abdominal organs into the pelvic cavity can lead to angulation of the intestinal tract, causing obstruction. Some studies have demonstrated that the extraperitoneal route can effectively reduce these complications Currently, robot-assisted surgery technology is widely utilized in urology. Studies have demonstrated that robot-assisted total extraperitoneal cystectomy and urinary diversion are less likely to disrupt abdominal organs, particularly the intestines. Identifying and locating membrane structures and layers with anatomical significance is crucial for navigating the correct anatomic space during the operation. The using of 3D laparoscopy or a robot-assisted extraperitoneal radical cystectomy aligns more closely with the 3D membrane anatomic concept. Furthermore, for younger patients,robot-assisted extraperitoneal radical cystectomy is more favorable for preserving reproductive function. For elderly patients, it is considered more safer.
Consequently, we aim to investigate whether robot-assisted extraperitoneal radical cystectomy is more advantageous for patients with MIBC or high-risk NMIBC.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| robit-assist transperitoneal laparoscopic radical cystectomy | No intervention | –robit-assist radical cystectomy was performed transperitoneal |
| robit-assist extraperitoneal laparoscopic radical cystectomy | Experimental | Procedure: robit-assist extraperitoneal laparoscopic radical cystectomyrobit-assist radical cystectomy was performed extraperitoneal |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Researchers evaluated patients with muscle invasive bladder cancer or high-risk non-muscular invasive bladder cancer who needed radical cystectomy.
- Willing to accept the operation and meet the surgical index: a) Absolute count of neutrophils≥1.5x109/L; b) Platelets≥100×109/L; c) Hemoglobin≥90g/L; d) International standardized ratio or activationPartial thrombin time≤1.5 Upper limit of normal value (ULN); e) calculated creatinine clearance rate≥1 ml/s; f) Total serum bilirubin≤1.5×ULN; g) AST, ALT and alkaline phosphatase≤2.5×ULN; h) Cardiopulmonary function indicates that it can tolerate major abdominal surgery;
- None of the pastHistory of abdominal surgery;
- 18 to 75 years old;
- ECOG physical state 0 or 1;
Key exclusion criteria (7 listed)
- Patients who refuse to receive radical cystectomy
- Researchers evaluate patients who are unable to tolerate radical cystectomy;
- There is a abdominal history of surgery;
- Have had a large-scale operation or major trauma within 28 days before joining the group;
- Have been vaccinated with live vaccine within 28 days before joining the group;
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| robit-assist extraperitoneal laparoscopic radical cystectomyrobit-assist laparoscopic radical cystectomy was performed extraperitoneal | Procedure or surgery | robit-assist extraperitoneal laparoscopic radical cystectomy |
Primary outcome
Complication rate
Time frame: through study completion, an average of 1 month, 3 month and 1 year
Complication rate after surgery
2 secondary outcomes
OS
Time frame: 5 years after surgery
PFS
Time frame: 5 years after surgery
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Feb 2024.
- Background: PubMed 36333236Lobo N, Afferi L, Moschini M, Mostafid H, Porten S, Psutka SP, Gupta S, Smith AB, Williams SB, Lotan Y. Epidemiology, Screening, and Prevention of Bladder Cancer. Eur Urol Oncol. 2022 Dec;5(6):628-639. doi: 10.1016/j.euo.2022.10.003. Epub 2022 Nov 1.
- Background: PubMed 33538338Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021 May;71(3):209-249. doi: 10.3322/caac.21660. Epub 2021 Feb 4.
- Background: PubMed 25533674Knowles MA, Hurst CD. Molecular biology of bladder cancer: new insights into pathogenesis and clinical diversity. Nat Rev Cancer. 2015 Jan;15(1):25-41. doi: 10.1038/nrc3817.
- Background: PubMed 32360052Witjes JA, Bruins HM, Cathomas R, Comperat EM, Cowan NC, Gakis G, Hernandez V, Linares Espinos E, Lorch A, Neuzillet Y, Rouanne M, Thalmann GN, Veskimae E, Ribal MJ, van der Heijden AG. European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines. Eur Urol. 2021 Jan;79(1):82-104. doi: 10.1016/j.eururo.2020.03.055. Epub 2020 Apr 29.
- Background: PubMed 35306500Haeuser L, Marchese M, Noldus J, Kibel AS, Carvalho F, Preston MA, Cooper Z, Trinh QD, Mossanen M. Association between Operative Time and Short-Term Radical Cystectomy Complications. Urol Int. 2023;107(3):273-279. doi: 10.1159/000522141. Epub 2022 Mar 18.
- Background: PubMed 1404624Parra RO, Andrus CH, Jones JP, Boullier JA. Laparoscopic cystectomy: initial report on a new treatment for the retained bladder. J Urol. 1992 Oct;148(4):1140-4. doi: 10.1016/s0022-5347(17)36843-x.
- Background: PubMed 30541538Cao Q, Li P, Yang X, Qian J, Wang Z, Lu Q, Gu M. Laparoscopic radical cystectomy with pelvic re-peritonealization: the technique and initial clinical outcomes. BMC Urol. 2018 Dec 12;18(1):113. doi: 10.1186/s12894-018-0424-6.
- Background: PubMed 9915445Kulkarni JN, Gulla RI, Tongaonkar HB, Kashyapi BD, Rajyaguru KB. Radical cystoprostatectomy: an extraperitoneal retrograde approach. J Urol. 1999 Feb;161(2):545-8. doi: 10.1016/s0022-5347(01)61946-3.
- Background: PubMed 23434097Zhu YP, Ye DW, Yao XD, Zhang SL, Dai B, Shen YJ, Wang CF. Defining good candidates for extraperitoneal cystectomy: results from random peritoneum biopsies of 136 cases. Urology. 2013 Apr;81(4):820-4. doi: 10.1016/j.urology.2012.11.057. Epub 2013 Feb 20.
- Background: PubMed 24356919Park DS, Gong IH, Choi DK, Hwang JH, Kang MH, Oh JJ. A feasibility study of peritoneum preservation in radical cystectomy with extraperitonealization of orthotopic neobladder for invasive high-grade bladder cancer: a preliminary analysis. Int Urol Nephrol. 2014 Jun;46(6):1107-13. doi: 10.1007/s11255-013-0632-7. Epub 2013 Dec 20.
- Background: PubMed 21110093De Nunzio C, Cicione A, Leonardo F, Rondoni M, Franco G, Cantiani A, Tubaro A, Leonardo C. Extraperitoneal radical cystectomy and ureterocutaneostomy in octogenarians. Int Urol Nephrol. 2011 Sep;43(3):663-7. doi: 10.1007/s11255-010-9876-7. Epub 2010 Nov 26.
- Background: PubMed 19777243Jentzmik F, Schostak M, Stephan C, Baumunk D, Lingnau A, Weikert S, Lein M, Miller K, Schrader M. Extraperitoneal radical cystectomy with extraperitonealization of the ileal neobladder: a comparison to the transperitoneal technique. World J Urol. 2010 Aug;28(4):457-63. doi: 10.1007/s00345-009-0476-z. Epub 2009 Sep 24.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Lv qiang, PhD study chair
The First Affiliated Hospital with Nanjing Medical University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing robit-assist extraperitoneal laparoscopic radical cystectomy in people with Bladder Cancer, run by The First Affiliated Hospital with Nanjing Medical University at 1 site in China.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 20 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Yang Xiao Yang, MD (+86 13951813528, yangxiao2915@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Complication rate (time frame: through study completion, an average of 1 month, 3 month and 1 year). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06253091, which also lists 22 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Feb 2024.