Lung cAncer Robotic Comparative Study

Official title

Comparing Outcomes for Minimally Invasive Techniques for Anatomic Lung Resection for Cancer - A Prospective, Comparative, Non-randomized, Open Label Post-market Observational Cohort Study Within Europe

Overview

To compare outcomes of minimally invasive surgical techniques for the treatment of early-stage non-small cell lung cancer.

Detailed description

Detection of lung cancer is occurring at increasingly earlier stages due to improved screening and the discovery of incidental nodules. Coinciding with this trend is recent data from two international randomized, control trials, RAVAL - (Robotic Lobectomy vs. Thoracoscopic Lobectomy for Early Stage Lung Cancer) and, JCOG0802 (The Japan Clinical Oncology Group) that show oncologic outcomes from segmentectomy are equivalent to lobectomy for cancers ≤2 cm. However, segmentectomy is a more complex technical operation that may not be easily feasible using video assisted thoracic surgery (VATS) but could be facilitated by robotic-assisted thoracic surgery (RATS), allowing improved vision, precision and controlled anatomic dissection.

The LARCS study is designed to understand the perioperative outcomes of patients and identify the real-world selection process of either VATS and RATS segmentectomy and lobectomy for lung cancers ≤2 cm. It aims to generate evidence to support integration of patient-centered care using minimally invasive technology.

In addition, health related quality of life captured in the study will also provide valuable insight into time to recovery, determining burden of the disease, and guide future treatment strategy.

Interventions

• Procedure Robotic Assisted Thoracic Surgery
  Surgeons will pre-determine to perform a segmentectomy or lobectomy using RATS.
• Procedure Video Assisted Thoracic Surgery
  Surgeons will pre-determine to perform a segmentectomy or lobectomy using VATS.

Primary outcome measures

• Patient reported Quality of Life 1 [Time frame: 1 month post surgery]
• Patient reported Quality of Life 2 [Time frame: 1 month post surgery]

Secondary outcome measures (1)

• Number of conversions from pre-operative surgical plan [Time frame: immediately post operative]

Eligibility criteria

Inclusion criteria

• Patient diagnosed with clinical stage IA1-2 non-small cell lung cancer at time of procedure
• Patient scheduled to undergo minimally invasive surgery for NSCLC with either da Vinci robotic assisted surgery or VATs
• Aged ≥ 18 years
• Must be willing and able to comply with study requirements
• Must indicate their understanding of the study and willingness to participate by signing an appropriate informed consent form

Exclusion criteria

• Patients with clinical stage IA3, II, III, and IV lung cancer
• Patient receiving a lobectomy/segmentectomy as an emergency procedure
• Patients receiving a lobectomy/segmentectomy for metastatic cancer
• Patients scheduled to receive a bilobectomy or sleeve-lobectomy
• Mental incapacity to understand or consent to study procedures
• Anticipated difficulty for patient to comply with protocol requirements
• Unable to comply with the follow up schedule
• Pregnant or are planning to become pregnant during the study
• Life expectancy < 12 months

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model

Cohort

Study locations

United Kingdom · 4 centers

• University Hospitals Bristol and Weston NHS Foundation Trust — Bristol
• University Hospitals Coventry and Warwickshire NHS Trust — Coventry
• Guy's and St Thomas' NHS Foundation Trust — London
• St Bartholomew Hospital — London

France · 3 centers

• AP-HM — Marseille
• CHU de Rouen — Rouen
• CHU de Toulouse — Toulouse

Germany · 2 centers

• Thoraxklinik — Heidelberg
• Krankenhaus Barmherzige Brüder — Regensburg

Denmark · 1 center

• Copenhagen University Hospital Rigshospitalet — Copenhagen

Italy · 1 center

• Azienda Ospedaliero Universitaria Pisana — Pisa

Norway · 1 center

• Akershus University Hospital — Loerenskog

Publications

• Patel YS, Hanna WC, Fahim C, Shargall Y, Waddell TK, Yasufuku K, Machuca TN, Pipkin M, Baste JM, Xie F, Shiwcharan A, Foster G, Thabane L. RAVAL trial: Protocol of an international, multi-centered, blinded, randomized controlled trial comparing robotic-assisted versus video-assisted lobectomy for early-stage lung cancer. PLoS One. 2022 Feb 2;17(2):e0261767. doi: 10.1371/journal.pone.0261767. eColl PMID 35108265
• Saji H, Okada M, Tsuboi M, Nakajima R, Suzuki K, Aokage K, Aoki T, Okami J, Yoshino I, Ito H, Okumura N, Yamaguchi M, Ikeda N, Wakabayashi M, Nakamura K, Fukuda H, Nakamura S, Mitsudomi T, Watanabe SI, Asamura H; West Japan Oncology Group and Japan Clinical Oncology Group. Segmentectomy versus lobectomy in small-sized peripheral non-small-cell lung cancer (JCOG0802/WJOG4607L): a multicentre, open- PMID 35461558

Identifiers

NCT: NCT06038227 · 1114332C

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗