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A randomised, controlled trial of surgical staging with endobronchial and endoscopic ultrasound for assessment of the mediastinum in lung cancer
Source of recordUK Clinical Trials Gateway
ISRCTNISRCTN97311620
Date ISRCTN assigned14/06/2007
Local reference number(s)HTA 06/302/216; P01198
Public titleA randomised, controlled trial of surgical staging with endobronchial and endoscopic ultrasound for assessment of the mediastinum in lung cancer
Scientific title
AcronymMEDUSA
Disease/condition/study domainNon small cell lung cancer
Study hypothesisThe hypothesis is that endobronchial/endoscopic staging is as accurate as surgical staging.
Design/methodologyA randomised controlled trial
Research ethics reviewApproved by:
1. The Cambridge 1 Research Ethics Committee (REC) (UK): 29th May 2007
2. Ghent University Hospitals REC (Belgium)

Approval pending for centres in Denmark and Germany. These centres will not be recruiting patients before REC approval has been granted.
Countries of trialUnited Kingdom, Denmark, Belgium and Germany
Participants - inclusion criteria1. Patients with a known diagnosis of non small cell lung cancer
2. Patients fit for bronchoscopy, endoscopy and surgical procedures

Male and female adult patients will be recruited - there is no upper age limit.
Participants - exclusion criteria1. Evidence of metastatic spread
2. Concurrent malignancy
3. Uncorrected coagulopathy
4. Inability to consent
Patient information material
Anticipated start date01/04/2007
Anticipated end date31/03/2009
Status of trialOngoing
Target number of participants142
InterventionsPatients will be randomised to have asurgical mediastinal staging or staging via Endobronchial and Endoscopic Ultrasound (EBUS/EUS).

EBUS/EUS (the research specific intervention):
This takes place in the bronchoscopy suite as a day case procedure under light sedation. The EBUS/EUS probes are passed down the trachea and oesophagus, respectively, and sequentially. Lymph nodes which have been identified by Computed Tomograpy (CT) scan (routine practice procedure) are biopsied and sent to the histopathology laboratory for histological analysis. The results of the histology inform the staging result. The staging result determines whether or not a patient is suitable for surgical resection of their lung cancer.

Surgical staging:
The surgical staging is conducted under general anaesthetic. Lymph nodes which have been identified by CT are biopsied and processed as above.

The histology samples will be analysed as soon as they are obtained. In those patients whose staging confirms that they are suitable to proceed to surgical resection, the true negative/false negative status of the histology samples will confirmed. Surgical resection occurs within 14 days of the staging.
Primary outcome measure(s)Sensitivity of Endobronchial and Endoscopic Ultrasound (EBUS/EUS).
Secondary outcome measure(s)1. Utility
2. Number of surgical procedures that can be avoided if EBUS/EUS is used
Sources of fundingNIHR Health Technology Assessment Programme - HTA (UK)
Sponsor namePapworth Hospital NHS Foundation Trust (UK)
Sponsor detailsPapworth Everard
Cambridge
United Kingdom
CB23 3RE
Sponsor telephone+44 (0)1480 364451
Sponsor fax+44 (0)1480 364550
Sponsor emailalistair.grant@papworth.nhs.uk
Sponsor websitehttp://www.papworthpeople.com/
Contact nameDr Robert Rintoul
Contact detailsPapworth Hospital NHS Foundation Trust
Papworth Everard
Cambridge
United Kingdom
CB23 8RE
Contact telephone+44 (0)1480 364342
Contact emailrobert.rintoul@papworth.nhs.uk
More informationFor more up-to-date information please go to the ISRCTN link below.
Link to record in ISRCTN RegisterISRCTN97311620
Date last extracted from ISRCTN register17/04/2008
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