Supplemental Oxygen - Effect on Occurrence of Subsequent Cancer After Abdominal Surgery (Follow-up of the PROXI Trial) (PROXI)

November 14, 2024 updated by: Lars S. Rasmussen

Perioperative Inspiratory Oxygen Fraction - Effect on Occurrence of Subsequent Cancer After Abdominal Surgery (Follow-up of the PROXI Trial)

Aim: to investigate the effect of a high inspiratory oxygen fraction (FiO2) given during and after laparotomy procedures on occurrence of a subsequent, new or recurrent, cancer diagnosis at a long-term follow-up.

Background: A high inspiratory oxygen fraction (FiO2 = 0.80) has been linked to prevention of surgical site infection, but the Danish randomized clinical multicenter trial, the PROXI trial, found no difference in frequency of surgical site infection. In fact, long-term mortality was significantly increased with a hazards ratio of 1.30 in patients receiving 80% oxygen, and this appeared to be statistically significant in patients undergoing cancer surgery, but not in non-cancer patients.

At this point, no convincing mechanism explains the observed increased mortality after hyperoxia, as the long-term pathophysiological effects of oxygen are not fully understood.

Primary hypothesis of this follow-up study of the PROXI trial: Use of 80% oxygen increase the frequency of patients with a subsequent, new or recurrent, cancer.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Actual)

1386

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Copenhagen, Denmark, DK-2100
        • Dept. of Anesthesia, HOC, Copenhagen University Hospital, Rigshospitalet

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Participants in the PROXI trial

Description

Inclusion Criteria:

  • Age 18 years or older.
  • Laparotomy, acute or elective. In case of gynaecological surgery only if malignancy is suspected (defined as risk of ovarian malignancy index >200 or a specimen with atypical or neoplastic cells).

Exclusion Criteria:

  • Other surgery within 30 days (except surgery in local anaesthesia).
  • Chemotherapy within 3 months.
  • Inability to give informed consent.
  • Inability to keep oxygen saturation above 90% without supplemental oxygen (measured preoperatively by pulse oximetry).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
80% oxygen group
During and 2 hrs after surgery
30% oxygen group
During and 2 hrs after surgery

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Frequency of patients with the composite outcome measure of either a subsequent, new or recurrent, cancer registration or a new histological specimen showing any neoplasm
Time Frame: 36-60 months after randomization
36-60 months after randomization

Secondary Outcome Measures

Outcome Measure
Time Frame
Frequency of patients with subsequent, new or recurrent, cancer registration at the Danish Cancer Registry
Time Frame: 15-39 months after randomization
15-39 months after randomization
Frequency of patients with new histological specimen in the Danish Patobank showing any neoplasm
Time Frame: 36-60 months after randomization
36-60 months after randomization
Frequency of patients with new histological specimen in the Danish Patobank showing neoplasm of a histological type not previously diagnosed
Time Frame: 36-60 months after randomization
36-60 months after randomization
Frequency of patients with cancer as diagnosis code at a readmission
Time Frame: 36-60 months after randomization
36-60 months after randomization
Frequency of patients with cancer as primary diagnosis code at a readmission
Time Frame: 36-60 months after randomization
36-60 months after randomization
Duration of cancer-free survival, as assessed by Kaplan-Meier statistics
Time Frame: 36-60 months after randomization
36-60 months after randomization

Other Outcome Measures

Outcome Measure
Time Frame
Type of new cancer registration
Time Frame: 15-39 months after randomization
15-39 months after randomization
Histological type of new cancer specimen
Time Frame: 36-60 months after randomization
36-60 months after randomization
Cause of death
Time Frame: 15-39 months after randomization
15-39 months after randomization

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Principal Investigator: Christian S Meyhoff, MD, PhD, Rigshospitalet, Denmark

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

October 1, 2006

Primary Completion (Actual)

September 1, 2011

Study Completion (Actual)

November 1, 2012

Study Registration Dates

First Submitted

November 5, 2012

First Submitted That Met QC Criteria

November 5, 2012

First Posted (Estimated)

November 7, 2012

Study Record Updates

Last Update Posted (Actual)

November 18, 2024

Last Update Submitted That Met QC Criteria

November 14, 2024

Last Verified

November 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

  • 2006-001710-32-follow-up
  • GCP-2006-101 (Other Identifier: Danish GCP-unit)
  • KF 02 306766 (Other Identifier: Ethics committee)

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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