Laparoscopic Versus Open Distal Pancreatectomy for Pancreatic Cancer: a Multicenter Randomized Controlled Trial
Multicenter Prospective Randomized Controlled Clinical Trial for Comparison Between Laparoscopic and Open Distal Pancreatectomy for Ductal Adenocarcinoma of the Pancreatic Body and Tail
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
* Purpose
To compare the safety and oncologic feasibility of open versus laparoscopic distal pancreatectomy for the treatment of pancreatic ductal adenocarcinoma (PDAC) of the body and tail.
* Study method
Multicenter prospective randomized controlled trial Noninferiority analysis Patients diagnosed with PDAC of the body and tail, without evidence of distant metastasis or direct invasion of adjacent organs, will be randomly allocated to either the open distal pancreatectomy group or the laparoscopic distal pancreatectomy group. Postoperative outcomes and survival data will be analyzed.
* Number of subjects
Sample size was calculated based on 2 year survival after pancreatectomy.
pA: 2 year survival of open distal pancreatectomy pB: 2 year survival of laparoscopic distal pancreatectomy
Null hypothesis: The 2 year survival of laparoscopic distal pancreatectomy is inferior to that of open distal pancreatectomy. H0: pA-pB≥δ
Alternative hypothesis: The 2 year survival of laparoscopic distal pancreatectomy is not inferior to that of open distal pancreatectomy. H1: pA-pB<δ
2 year survival of pancreatectomy (Shin et al, 2015) is 55.9% for open and 64.3% for laparoscopic distal pancreatectomy.
When α=5%, 1-β=80%, δ=10%, and one-sided analysis is performed with a power of 80%, the required number of subjects is 111 for each group.
With a drop rate of 10%, the final number of each group is 122, with a total of 244.
* Primary and Secondary endpoints
Primary endpoint: 2 year overall survival
Secondary endpoint: R0 resection rate, 2 year disease free survival, 2 year recurrence rate, complication rate, postoperative hospital stay, operative time, estimated blood loss
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Jun Suh Lee, M.D. Ph.D.
- Phone Number: +82-10-2747-6320
- Email: rudestock@gmail.com
Study Contact Backup
- Name: Yoo-Seok Yoon, M.D. Ph.D.
- Email: arsyun@gmail.com
Study Locations
-
-
Kyeonggi-do
-
Seongnam-si, Kyeonggi-do, Korea, Republic of, 13620
- Recruiting
- Seoul National University Bundang Hospital
-
Contact:
- Jun Suh Lee, M.D., Ph.D.
- Phone Number: +82-10-2747-6320
- Email: rudestock@gmail.com
-
Principal Investigator:
- Ho-Seong Han, M.D.,Ph.D.
-
Sub-Investigator:
- Yoo-Seok Yoon, M.D.,Ph.D.
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Eastern Cooperative Oncology Group (ECOG) performance score 0-2
- Pancreatic ductal adenocarcinoma that is pathologically confirmed or shows characteristic radiologic features
- Patients with resectable pancreatic cancer at the time of surgery (Including borderline resectable pancreatic cancer at the time of diagnosis or Locally advanced pancreatic cancer after chemotherapy or radiation therapy)
- Lesion (within pancreatic body and tail) is located to the left of the left branch of the hepatic portal vein
- No remote metastasis in preoperative imaging and not adjacent to the superior mesenteric vein, superior mesenteric artery, and abdominal artery
- Patients without invasion of adjacent organs other than the left adrenal gland and mesocolon
- Patients with informed consent
Exclusion Criteria:
- Patients with remote metastasis at the time of diagnosis of pancreatic cancer
- History of other malignancy (Inclusive if there is no evidence of recurrence after 5 years of treatment)
- In the case of invasion of other organs other than the left adrenal gland and mesocolon
- Where major vascular resection, such as the portal vein or abdominal artery, is required to secure negative resection
- Recurrent pancreatic cancer
- Patients with underlying diseases at high risk of general anesthesia
- Preperitoneal or other organ metastases found during surgery
- In case of previously undergone pancreatic resection
- Other subject whom the investigator deems inappropriate
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: Laparoscopic distal pancreatectomy
Patients receiving laparoscopic distal pancreatectomy for pancreatic tail and body cancer
|
Laparoscopic resection of the diseased portion of the pancreas for treatment of pancreatic cancer
|
|
ACTIVE_COMPARATOR: open distal pancreatectomy
Patients receiving open distal pancreatectomy for pancreatic tail and body cancer
|
Open resection of the diseased portion of the pancreas for treatment of pancreatic cancer
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
2 year survival
Time Frame: 2 years
|
Overall survival at 2 years after surgery
|
2 years
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Ho-Seong Han, M.D. Ph.D., Seoul National University Bundang Hospital
Publications and helpful links
General Publications
- Yoon YS, Lee KH, Han HS, Cho JY, Jang JY, Kim SW, Lee WJ, Kang CM, Park SJ, Han SS, Ahn YJ, Yu HC, Choi IS. Effects of laparoscopic versus open surgery on splenic vessel patency after spleen and splenic vessel-preserving distal pancreatectomy: a retrospective multicenter study. Surg Endosc. 2015 Mar;29(3):583-8. doi: 10.1007/s00464-014-3701-9. Epub 2014 Jul 9.
- Yoon YS, Lee KH, Han HS, Cho JY, Ahn KS. Patency of splenic vessels after laparoscopic spleen and splenic vessel-preserving distal pancreatectomy. Br J Surg. 2009 Jun;96(6):633-40. doi: 10.1002/bjs.6609.
- Shin SH, Kim SC, Song KB, Hwang DW, Lee JH, Lee D, Lee JW, Jun E, Park KM, Lee YJ. A comparative study of laparoscopic vs. open distal pancreatectomy for left-sided ductal adenocarcinoma: a propensity score-matched analysis. J Am Coll Surg. 2015 Feb;220(2):177-85. doi: 10.1016/j.jamcollsurg.2014.10.014. Epub 2014 Oct 31.
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 (ACTUAL)
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
- SNUBH-GS-HBP4
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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