Gurusamy, K, Corrigan, N, Croft, J orcid.org/0000-0001-7586-3394 et al. (14 more authors) (2018) Liver resection surgery versus thermal ablation for colorectal LiVer MetAstases (LAVA): study protocol for a randomised controlled trial. Trials, 19. 105. ISSN 1745-6215
Abstract
Background: Although surgical resection has been considered the only curative option for colorectal liver metastases (CLM), thermal ablation has recently been suggested as an alternative curative treatment. A prospective randomised trial is required to define the efficacy of resection vs ablation for the treatment of colorectal liver metastases.
Methods: Design and setting: This is a multicentre, open, randomised controlled non-inferiority trial design with internal pilot and will be performed in tertiary liver centres in UK and The Netherlands.
Participants: Eligible patients will be those with colorectal liver metastases at high surgical risk because of their age, co-morbidities or tumour burden and who would be suitable for liver resection or thermal ablation.
Intervention: Thermal ablation as per local policy.
Control: Surgical liver resection performed as per centre protocol.
Co-interventions: Further chemotherapy will be offered to patients as per current practice.
Outcomes: Pilot study: Same as main study and in addition patients and clinicians’ acceptability of the trial to assist in optimisation of recruitment.
Primary outcome: Disease-free survival (DFS) at two years post randomisation.
Secondary outcomes: Overall survival, timing and site of recurrence, additional therapy after treatment failure, quality of life, complications, length of hospital stay, costs, trial acceptability, DFS measured from end of intervention.
Follow-up: 24 months from randomisation; five-year follow-up for overall survival.
Sample size: 330 patients to demonstrate non-inferiority of thermal ablation.
Discussion: This trial will determine the effectiveness and cost-effectiveness of thermal ablation vs surgical resection for high-risk people with colorectal liver metastases, and guide the optimal treatment for these patients.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | (c) 2018. The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
Keywords: | Randomised controlled trial; Cost-benefit analysis; Liver; Neoplasm metastasis; Colorectal neoplasms; Hepatectomy; Ablation techniques |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Clinical Trials Research (LICTR) (Leeds) |
Funding Information: | Funder Grant number NIHR National Inst Health Research 524157 |
Depositing User: | Symplectic Publications |
Date Deposited: | 21 Jun 2018 11:49 |
Last Modified: | 21 Jun 2018 11:49 |
Status: | Published |
Publisher: | BioMed Central |
Identification Number: | 10.1186/s13063-018-2499-5 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:132379 |