Open Versus Laparoscopically-assisted Esophagectomy for Cancer
Open vs Laparoscopically-assisted Esophagectomy for Cancer: A Multicentric Phase III Prospective Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
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Bordeaux, France, 33604
- Hôpital du Haut Lévêque
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Boulogne-Billancourt, France, 92 100
- Hopital Ambroise Pare Ap-Hp
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Clermont-Ferrand, France, 63 058
- Hôtel Dieu
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Colombes, France, 92 701
- Hôpital Louis Mourier
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Lyon, France, 69 317
- Hôpital de La Croix Rousse
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Marseille, France, 13 274
- Hopital St Marguerite Ap-Hm
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Paris, France, 75014
- Institut Mutualiste Montsouris
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Paris, France, 75 010
- Hopital St Louis Ap-Hp
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Rennes, France, 35 033
- Hopitalpontchaillou
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Strasbourg, France, 67 098
- Hopitaux Universitaires de Strasbourg
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Toulouse, France, 31 059
- Hopital Purpan
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Squamous cell or adenocarcinoma of the thoracic esophagus T1, T2, T3, N0-N1, M0, before any treatment
- Middle or lower third esophageal carcinoma, junctional tumor Siewert type I
- Patients who underwent or not neoadjuvant chemotherapy or chemoradiation
- Tumor deemed to be resectable in a curative intent at the preoperative setting
- Age less than 75 years old, OMS status 0, 1 or 2
- Patient who can undergo one or the other surgical modality
- Written informed consent form
- Possible follow-up
Exclusion Criteria:
General criteria: PO2 ≤ 60 mmHg; PCO2 > 45 mmHg; FEV ≤ 1000 ml/sec
- Hepatic cirrhosis
- Recent myocardial infarction (in the previous 6 months) or progressive coronary disease
- Distal arteritis (Leriche-Fontaine stage II upwards)
- Concomitant cancer, other than subcarinal esophageal cancer
Disease-related factors
- Invasion of subclavicular lymph nodes in a clinical examination or on biospy
- Lymph nodes near the origin of the celiac artery with a diameter ≥ 1 cm on CT or that appear to be suspect on endoscopic ultrasound (to differentiate them from the paracardial or left gastric lymph nodes, which does not constitute an exclusion criterion)
- Recurrent nerve palsy
- Evidence of extension to the tracheobronchial tree
- Signs of mediastinal invasion (vertebral contact, aortic contact ≥ 90°, or invasion of nonresectable neighboring organs such as the aorta, trachea, main bronchi, etc.)
- Distant metastasis
Laparoscopy-related factors
- Patient presenting a general contraindication to laparoscopy
- A history of median or subcostal laparotomy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Laparoscopically-assisted esophagectomy
Laparoscopically-assisted esophagectomy: standard abdominal procedure of gastric mobilisation but through laparoscopic route.
Right thoracotomy as usual.
|
To compare during the abdominal approach the laparoscopic route to the open route for gastric mobilization.
Thoracic approach will be the same between the 2 arms through thoracotomy with extended two field lymphadenectomy
Other Names:
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Active Comparator: Open esophagectomy
Conventional open esophagectomy: Esophagectomy with extended 2-field lymphadenectomy through laparotomy and right thoracotomy (Ivor-Lewis standard procedure)
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To compare during the abdominal approach the laparoscopic route to the open route for gastric mobilization.
Thoracic approach will be the same between the 2 arms through thoracotomy with extended two field lymphadenectomy
Other Names:
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
To decrease postoperative major 30-days morbidity from 45% in the open arm to 25% in the laparoscopically-assisted arm.
Time Frame: 30 days
|
30 days
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
overall survival
Time Frame: 2 years
|
2 years
|
|
quality of life
Time Frame: 2 years
|
2 years
|
|
overall morbidity
Time Frame: 30 days
|
30 days
|
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disease free survival
Time Frame: 2 years
|
2 years
|
|
economical interest of the surgical technique apprehended through a hospital point of view
Time Frame: 6 months
|
6 months
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Christophe Mariette, MD, PhD, University Hospital of Lille, France
Publications and helpful links
General Publications
- Nuytens F, Dabakuyo-Yonli TS, Meunier B, Gagniere J, Collet D, D'Journo XB, Brigand C, Perniceni T, Carrere N, Mabrut JY, Msika S, Peschaud F, Prudhomme M, Markar SR, Piessen G; Federation de Recherche en Chirurgie (FRENCH) and French Eso-Gastric Tumors (FREGAT) Working Groups. Five-Year Survival Outcomes of Hybrid Minimally Invasive Esophagectomy in Esophageal Cancer: Results of the MIRO Randomized Clinical Trial. JAMA Surg. 2021 Apr 1;156(4):323-332. doi: 10.1001/jamasurg.2020.7081.
- Briez N, Piessen G, Bonnetain F, Brigand C, Carrere N, Collet D, Doddoli C, Flamein R, Mabrut JY, Meunier B, Msika S, Perniceni T, Peschaud F, Prudhomme M, Triboulet JP, Mariette C. Open versus laparoscopically-assisted oesophagectomy for cancer: a multicentre randomised controlled phase III trial - the MIRO trial. BMC Cancer. 2011 Jul 23;11:310. doi: 10.1186/1471-2407-11-310.
- Mariette C, Markar SR, Dabakuyo-Yonli TS, Meunier B, Pezet D, Collet D, D'Journo XB, Brigand C, Perniceni T, Carrere N, Mabrut JY, Msika S, Peschaud F, Prudhomme M, Bonnetain F, Piessen G; Federation de Recherche en Chirurgie (FRENCH) and French Eso-Gastric Tumors (FREGAT) Working Group. Hybrid Minimally Invasive Esophagectomy for Esophageal Cancer. N Engl J Med. 2019 Jan 10;380(2):152-162. doi: 10.1056/NEJMoa1805101.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 2008_24/0904
- PHRC 2008/1907 (Other Identifier: DHOS)
- 2009-A00144-53. (Other Identifier: ID-RCB number, ANSM)
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