Bronchogenic Carcinoma
Conditions
Keywords
Lung, Cancer, Staging, Endobronchial, Ultrasound, Endoscopic
Brief summary
In the UK, staging of lung cancer is time consuming (taking on average more than 3 weeks), costly and inaccurate in up to 20% of cases. The investigators wish to determine whether using the newer techniques of endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS) improves lung cancer staging. The investigators' hypothesis is that EUS (endoscopic ultrasound) or EBUS (endobronchial ultrasound guided transbronchial needle aspirate) as a first test after CT scan in the diagnosis and staging of lung cancer will result in a reduction in the time from first outpatient appointment to treatment decision, a reduction in the total number of scans and investigative operations, fewer outpatient attendances and a reduction in healthcare costs.
Interventions
PROCEDUREEndobronchial or Endoscopic Ultrasound
Patients with anterior mediastinal or subcarinal disease will undergo EBUS. Patients with posterior, subcarinal or AP window disease will undergo EUS. Patients with no mediastinal disease on CT scan will undergo EBUS.
PROCEDUREBronchoscopy, CT-guided biopsy, PET scan, Mediastinoscopy
Investigations will be determined by the multi-disciplinary team responsible for the patient
Sponsors
North Middlesex University Hospital
Barnet and Chase Farm Hospitals NHS Trust
The Whittington Hospital NHS Trust
University College London Hospitals
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Consecutive patients suspected of lung cancer on CT scan * Written informed consent * Able to tolerate bronchoscopy and thoracic surgery
Exclusion criteria
* Evidence of severe or uncontrolled systemic disease that makes it undesirable for the patient to participate in the trial * Any disorder making reliable informed consent impossible * Patients with extra-thoracic disease, supraclavicular lymphadenopathy or pleural effusion
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Time from first outpatient appointment to decision to treat | 1 - 3 months |
Secondary
| Measure | Time frame |
|---|---|
| The healthcare costs for diagnosing and staging lung cancer | End of study |
| The number of tests and outpatient visits a patient requires to be diagnosed and staged with lung cancer | 1 - 3 months |
| The proportion of lung cancer patients that are diagnosed and staged with a single test after CT scan | 1 - 3 months |
| The time from first outpatient appointment to treatment | 1 - 3 months |
| The number of futile thoracotomies | 1 - 3 years |
Countries
United Kingdom
Outcome results
None listed