Laparoscopy-Assisted Surgery for Carcinoma of the Low Rectum (LASRE)
Laparoscopy-Assisted Surgery for Carcinoma of the Low Rectum : A Prospective, Multi-Center, Randomized, Open-Label, Parallel Group, Non-Inferiority Clinical Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Fujian
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Fuzhou, Fujian, China, 350001
- Fujian Medical University Union Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- histologically proven rectal adenocarcinoma
- inferior edge of the tumor located within 5 cm from the dentate line as determined by rigid proctoscopy
- diagnosis of rectal cancer amenable to curative surgery either by anterior resection or abdominoperineal resection or extralevator abdominoperineal excision
- T3-4a,N0 or T1-4a,N1-2 treated with neoadjuvant chemoradiotherapy
- no evidence of distant metastases
- tumor size <6cm
- sufficient organ function
- no contraindication to laparoscopic surgery
- without other malignancies in medical history
Exclusion Criteria:
- concurrent or previous diagnosis of invasive cancer within 5 years
- locally advanced cancers requiring en bloc multivisceral resection
- intestinal obstruction
- intestinal perforation
- history of colorectal surgery
- American Society of Anesthesiologists(ASA) class 4 or 5
- pregnant or breast-feeding women
- history of mental disorder
- participation in another rectal cancer clinical trial relating to surgical technique
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: Arm I
Patients undergo laparoscopic-assisted rectal resection.
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Arm I: Patients undergo laparoscopic-assisted rectal resection.
|
|
ACTIVE_COMPARATOR: Arm II
Patients undergo conventional open rectal resection.
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Arm II: Patients undergo conventional open rectal resection.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
3 years disease-free survival
Time Frame: 3 years
|
Disease-free survival is defined as the time from date of surgery to the date of rectal cancer recurrence or metastasis or cancer-related death (locoregional or distant recurrence) .
|
3 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pathologic outcomes
Time Frame: 1 week post operatively
|
Pathologic outcomes are defined as TME quality, negative CRM and negative DRM, length of proximal resection margin (PRM), length of DRM, and the number of retrieved lymph nodes.The TME quality was graded based on the criteria proposed by Nagtegaal et al. as complete, nearly complete, or incomplete.Positive resection margin, including circumferential resection margin (CRM) and distal resection margin (DRM), was defined as the presence of cancer cells within 1 mm from the cut edge.
|
1 week post operatively
|
|
30-day postoperative complications
Time Frame: 1 month within operatively
|
Thirty-day postoperative complications included any complications occurring within 30 days after surgery.
Postoperative complications were graded according to the Clavien-Dindo classification.
Severe complications were defined as Clavien-Dindo III-V.
|
1 month within operatively
|
|
30-day postoperative mortality
Time Frame: 30 days post operatively
|
Thirty-day operative mortality is defined as deaths occurring from any cause during the first 30 postoperative days.
|
30 days post operatively
|
|
Overall survival
Time Frame: 3 and 5 years post operatively
|
Overall survival is defined as the time from date of surgery to date of death from any cause.
|
3 and 5 years post operatively
|
|
Locoregional recurrence rate
Time Frame: 3 and 5 years post operatively
|
Locoregional recurrence was defined as the presence of any anastomotic, pelvic or perineal tumour documented by clinical and/or pathological examination.
|
3 and 5 years post operatively
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Operative time
Time Frame: Day 1
|
Operative time is defined as the time from skin incision to the completion of skin suture.
|
Day 1
|
|
Conversion to Open Surgery
Time Frame: Day 1
|
The conversion is defined as any part of the mesorectal dissection using the traditional open surgery.
The surgeon decided the conversion after considering patient safety, technical difficulties, and relevant conditions influencing the completion of TME.
|
Day 1
|
|
Estimated blood loss
Time Frame: Day 1
|
Estimated blood loss will be measured according to the suction and the weight of wet gauze, and then minus the irrigation.
|
Day 1
|
|
Length of hospital stay
Time Frame: from the completion of the surgery till discharge from hospital
|
Duration of hospital stay measured from the day of surgery until the day of discharge from hospital.
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from the completion of the surgery till discharge from hospital
|
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Patient self-reported bladder and sexual function
Time Frame: at postoperative 3,6 and 12 months
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Patient self-reported bladder and sexual function as assessed by the International Prostatic Symptom Score(I-PSS©) for male and female bladder function and the International Index of Erectile Function (IIEF) Female Sexual Function Index(FSFI©) for sexual function.
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at postoperative 3,6 and 12 months
|
|
Health related quality of life
Time Frame: at postoperative 3,6 and 12 months
|
Health related quality of life assessed by EORTC CR29 score, EORTC CR30 score
|
at postoperative 3,6 and 12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Pan Chi, MD, Fujian Medical University Union Hospital
Publications and helpful links
General Publications
- Jiang WZ, Xu JM, Xing JD, Qiu HZ, Wang ZQ, Kang L, Deng HJ, Chen WP, Zhang QT, Du XH, Yang CK, Guo YC, Zhong M, Ye K, You J, Xu DB, Li XX, Xiong ZG, Tao KX, Ding KF, Zang WD, Feng Y, Pan ZZ, Wu AW, Huang F, Huang Y, Wei Y, Su XQ, Chi P; LASRE trial investigators. Short-term Outcomes of Laparoscopy-Assisted vs Open Surgery for Patients With Low Rectal Cancer: The LASRE Randomized Clinical Trial. JAMA Oncol. 2022 Sep 15;8(11):1607-15. doi: 10.1001/jamaoncol.2022.4079. Online ahead of print.
- Chi P. [Laparoscopic total mesorectum excision with the guidance of membrane anatomy]. Zhonghua Wei Chang Wai Ke Za Zhi. 2016 Oct 25;19(10):1088-1091. Chinese.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ANTICIPATED)
Primary Completion
Study Completion (ANTICIPATED)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
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
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 0925-0586
- LASRE (REGISTRY: Laparoscopy-assisted Surgery for Carcinoma of the Low Rectum)
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