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Revision to improve cell recovery
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The purpose of this pilot study is to determine if washing out the bladder with large volumes of saline after surgical removal of bladder tumors helps to decrease the number of loose cells floating within the bladder after surgery. Anticipated decrease in tumor recurrence and/or progression rates will be measured.
Bladder tumor recurrence after resection of non-muscle invasive bladder cancer (NMIBC) occurs in 50-70% of patients despite the use of adjuvant anticancer therapy after surgery. This is a single-arm, non-randomized pilot study looking to determine whether post-Transurethral Resection of Bladder Tumor (TURBT) cells counts differ significantly between continuous washout of the bladder (CBI) with normal saline compared to pre-CBI wash out. Anticipated decrease in tumor recurrence and/or progression rates will also be measured, and each participant will act as their own internal control.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Continuous Bladder Irrigation (CBI) | Experimental | Each subject will have a TURBT procedure performed per standard of care procedure, which will be followed by the study intervention - Continuous Bladder Irrigation (CBI) for up to two hours after procedure. Six samples of discarded bladder irrigation will be collected from each participant (N=20) immediately after TURBT and after the completion of each liter of normal saline 0.9% irrigation (1 to 5 L) for a total of 120 samples. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CBI | Procedure | CBI with 5 liters normal saline in 1 liter increments up to 2 hours after TURBT procedure. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change in mean cells count before versus after liter 1 of CBI | The mean cell count obtained before CBI will be compared to the mean cell counts obtained after each liter (5L total) of CBI. | Immediately after CBI procedure. |
| Change in mean cells count before versus after liter 2 of CBI | The mean cell count obtained before CBI will be compared to the mean cell counts obtained after each liter (5L total) of CBI. | Immediately after CBI procedure. |
| Change in mean cells count before versus after liter 3 of CBI | The mean cell count obtained before CBI will be compared to the mean cell counts obtained after each liter (5L total) of CBI. | Immediately after CBI procedure. |
| Change in mean cells count before versus after liter 4 of CBI | The mean cell count obtained before CBI will be compared to the mean cell counts obtained after each liter (5L total) of CBI. | Immediately after CBI procedure. |
| Change in mean cells count before versus after liter 5 of CBI | The mean cell count obtained before CBI will be compared to the mean cell counts obtained after each liter (5L total) of CBI. | Immediately after CBI procedure. |
| Measure | Description | Time Frame |
|---|---|---|
| Recurrence rate of patients who underwent CBI post TURBT. | Participants are followed for additional 2 years during which time, they will receive standard of care. Data collected during their 2-year follow up includes monitoring for recurrence and progression rates. Recurrence is defined as the identification of a recurrent tumor of same grade and or stage or lower | 2 years after end of treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Lee Ponsky | University Hospitals Cleveland Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospitals Seidman Cancer Center, Case Comprehensive Cancer Center | Cleveland | Ohio | 44106 | United States |
Individual participant data that underlie the results reported in the published article, after deidentification (text, tables, figures).
Beginning 9 months and ending 36 months following article publication
To be shared with investigators whose proposed use of the data has been approved by an independent review committee ("learned intermediary") identified for this purpose. For individual participant data meta-analysis.
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| ID | Term |
|---|---|
| D000093284 | Non-Muscle Invasive Bladder Neoplasms |
| D001749 | Urinary Bladder Neoplasms |
| ID | Term |
|---|---|
| D002277 | Carcinoma |
| D009375 | Neoplasms, Glandular and Epithelial |
| D009370 | Neoplasms by Histologic Type |
| D009369 | Neoplasms |
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Single arm where each patient will act as his/her own internal control (cell count before and after CBI).
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| Progression rate of patients who underwent CBI post TURBT. | Participants are followed for additional 2 years during which time, they will receive standard of care. Data collected during their 2-year follow up includes monitoring for recurrence and progression rates. Progression is defined as a recurrent tumor of higher grade and or stage | 2 years after end of treatment |
| D014571 |
| Urologic Neoplasms |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D001745 | Urinary Bladder Diseases |
| D014570 | Urologic Diseases |
| D052801 | Male Urogenital Diseases |