Pleuroscopy First Versus Thoracentesis First in Patients With Suspected Malignant Pleural Effusions

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18+
SponsorIcahn School of Medicine at Mount Sinai

About this trial

This is a randomized control trial of patients with suspected malignant pleural effusions to compare whether patients who have a thoracentesis or pleuroscopy (pleural biopsy) obtain an adequate biopsy, achieve a diagnosis, and begin cancer-directed therapy faster.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Referral for diagnostic pleural procedure.

Age ≥ 18 years.

Suspected malignant pleural effusion (Suggestive radiologic appearance (based on computed tomography or positron emission tomography) OR suspected cancer with associated effusion.)

Disqualifiers

Inability to provide informed consent.

Needs emergent drainage.

Pleural effusion is known to be malignant.

Suspected transudative, infectious or inflammatory effusion etiology.

Trial design

Design model

Parallel

Treatments tested in this trial

  • Pleuroscopy first

    Procedure/Surgery

    Pleuroscopies are performed under moderate sedation with local anesthesia. Through a 1-cm incision a camera is introduced into the pleural space and the space is inspected after draining all fluid. Targeted biopsies under direct visualization are obtained using forceps. The aspirated fluid and biopsies obtained are sent to the cytology and pathology laboratories for analysis.

  • Thoracentesis first

    Procedure/Surgery

    Thoracenteses are performed under local anesthesia with the insertion of a 5-8Fr catheter into the pleural space. The aspirated fluid obtained is sent to the cytology laboratory for analysis.

Treatment groups

98 Participants
are divided into 2 treatment groups
Group A: Pleuroscopy firstActive comparator 1 intervention
Group B: Thoracentesis firstActive comparator 1 intervention

Trial outcomes

Primary outcomes

1

Proportion of biopsies adequate for definitive diagnosis

Proportion of biopsies adequate for definitive diagnosis

Time frame
6 months

Secondary outcomes

1

Time from initial visit with pulmonologist to procedure

Time from initial visit with pulmonologist to procedure

Time frame
6 months
2

Time from initial procedure to diagnosis

Time from initial procedure to diagnosis

Time frame
6 months
3

Time from initial visit with pulmonologist to diagnosis

Time from initial visit with pulmonologist to diagnosis

Time frame
6 months
4

Time from initial visit with pulmonologist to seeing oncologist

Time from initial visit with pulmonologist to seeing oncologist

Time frame
6 months

Other outcomes

Sponsors and contacts

Click on the lead sponsor to view all of their trials.