Staging by thoracoscopy in potentially radically treatable non-small cell lung cancer associated with minimal pleural effusion (STRATIFY) study: a prospective multicentre study
Ferguson, J. Alexander, L. Kelly, C. Chalmers, A. Rahman, N. Holme, J Grundy, S. Ahmed, L. Maskell, N. Cowell, G.
Ferguson, J.
Alexander, L.
Kelly, C.
Chalmers, A.
Rahman, N.
Holme, J
Grundy, S.
Ahmed, L.
Maskell, N.
Cowell, G.
Citations
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Abstract
Introduction: Pleural effusion (PE) is common in patients with lung
cancer, but routine imaging and fluid cytology offer low sensitivity
for detection of pleural metastases. Previous retrospective studies
report an association between mini-PE (defined as an ipsilateral PE
too small to be safely aspirated, or in which fluid cytology is negative)
and adverse survival. This may be critical in patients with otherwise
radically treatable lung cancer, where mini-PE may reflect occult
pleural metastases (OPM). The STRATIFY (Staging by Thoracoscopy
in Potentially Radically Treatable Non-Small Cell Lung Cancer
Associated with Minimal Pleural Effusion) study is a multicentre,
prospective study designed to determine the true prevalence of
OPM in those with otherwise potentially curable NSCLC. The study
will determine the role of staging local anaesthetic thoracoscopy
(LAT) in this setting.
Methods: 96 patients identified at outpatient clinic or multidisciplinary
team meetings (MDT) will undergo LAT to obtain
pleural biopsies. All participants will have a full diagnostic work up
including confirmatory pathology, MDT discussion and provisional
treatment plans prior to entering STRATIFY. The primary endpoint
will be the true prevalence of OPM, as defined by the by the
proportion of recruited patients with NSCLC cells in parietal pleural
biopsies or pleural fluid obtained during LAT. Additionally, we will
recruit 42 patients into an MRI sub-study. This will involve multiparametric
MRI prior to LAT to assess a) the performance of noninvasive
MRI measures of OPM b) potential alternative measures
of adverse outcome, including cardiac function and altered body
composition.
Results: Final numbers of OPM/ non-OPM cases will depend on the
incidence of OPM in the study population (estimated at 70%).
Conclusion: The study has been approved by the West of Scotland
Research Ethics Committee (Ref: 19/WS/0093). A Study Management
Group meets monthly. Results will be published in peer-reviewed
journals, presented at international meetings and disseminated to
patient groups.
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Ferguson J, Alexander L, Kelly C, Chalmers A, Rahman N, Holme J, et al. Staging by thoracoscopy in potentially radically treatable non-small cell lung cancer associated with minimal pleural effusion (STRATIFY) study: a prospective multicentre study. Lung Cancer. 2020;139:S92-S