GCSSG-SPNX: Trial to Evaluate Splenectomy in Total Gastrectomy for Proximal Gastric Carcinoma: JCOG0110

September 20, 2016 updated by: Haruhiko Fukuda

Randomized Controlled Trial to Evaluate Splenectomy in Total Gastrectomy for Proximal Gastric Carcinoma: JCOG0110

The purpose of this study is to evaluate the role of splenectomy in potentially curative total gastrectomy for proximal gastric carcinoma in terms of survival benefit and post-operative morbidity.

Study Overview

Detailed Description

European clinical trials of gastrectomy showed that splenectomy is an important risk factor for post-operative morbidity and mortality. Retrospective comparisons suggested that splenectomy is associated with poor long term survival. However, Japanese studies revealed that 20 - 30 % of patients with non-early carcinoma in the proximal stomach have nodal metastasis in the splenic hilum and therefore, pancreas-preserving splenectomy is part of the standard operation in specialized centers where splenectomy is not considered a risk factor for operative mortality. There have been no prospective randomized trials to evaluate the survival benefit of splenectomy in total gastrectomy for proximal gastric cancer.

Comparison: Total gastrectomy with pancreas-preserving splenectomy versus total gastrectomy without splenectomy

Study Type

Interventional

Enrollment (Actual)

500

Phase

  • Phase 3

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

    • Aichi
      • Nagoya,Chikusa-ku,Kanokoden,1-1, Aichi, Japan, 464-8681
        • Aichi Cancer Center Hospital
      • Toyoake,Kutsukake-cho,Dengakugakubo,1-98, Aichi, Japan, 470-1192
        • Fujita Health University
    • Chiba
      • Kashiwa,Kashiwanoha,6-5-1, Chiba, Japan, 277-8577
        • National Cancer Center Hospital East
    • Ehime
      • Matsuyama,Horinouchi,13, Ehime, Japan, 790-0007
        • National Hospital Organization Shikoku Cancer Center
    • Gifu
      • Gifu,Kashima-cho,7-1, Gifu, Japan, 500-8323
        • Gifu Municipal Hospital
    • Hiroshima
      • Hiroshima,Naka-ku,Motomachi,7-33, Hiroshima, Japan, 730-8518
        • Hiroshima City Hospital
    • Hyogo
      • Itami,Koyaike,1-100, Hyogo, Japan, 664-8540
        • Itami City Hospital
    • Iwate
      • Morioka,Uchimaru,19-1, Iwate, Japan, 020-8505
        • Iwate Medical University
    • Kagoshima
      • Kagoshima,Sakuragaoka,8-35-1, Kagoshima, Japan, 890-8520
        • Kagoshima University,Faculty of Medicine
    • Kanagawa
      • Yokohama,Asahi-ku,Nakao,1-1-2, Kanagawa, Japan, 241-0815
        • Kanagawa Cancer Center
    • Kyoto
      • Kyoto,Kamigyo-ku,Kamanza-Marutamachi,355-5, Kyoto, Japan, 602-8026
        • Kyoto Second Red Cross Hospital
    • Miyagi
      • Natori,Medeshima-Shiode,Nodayama,47-1, Miyagi, Japan, 981-1293
        • Miyagi Cancer Center
      • Sendai,Miyagino-ku,Miyagino,2-8-8, Miyagi, Japan, 983-8520
        • National Hospital Organization, Sendai Medical Center
    • Niigata
      • Nagaoka,Kawasaki,2041, Niigata, Japan, 940-8653
        • Nagaoka Chuo General Hospital
      • Niigata,Kawagishi-cho,2-15-3, Niigata, Japan, 951-8566
        • Niigata Cancer Center Hospital
      • Tsubame,Sawatari,633, Niigata, Japan, 959-1228
        • Tsubame Rosai Hospital
    • Oita
      • Oita1-1,Hasama-machi,Oogaoka, Oita, Japan, 879-5593
        • Oita University Fuculty of Medicine
    • Osaka
      • Osaka,Chuo-ku,Hoenzaka,2-1-14, Osaka, Japan, 540-0006
        • Osaka National Hospital
      • Osaka,Higashinari-ku,Nakamichi,1-3-3, Osaka, Japan, 537-8511
        • Osaka Medical Center for Cancer and Cardiovascular Diseases
      • Osaka-Sayama,Ohno-higashi,377-2, Osaka, Japan, 589-8511
        • Kinki University School of Medicine
      • Sakai,Minamiyasuicho,1-1-1, Osaka, Japan, 590-0064
        • Sakai Municipal Hospital
      • Takatsuki,Daigakucho,2-7, Osaka, Japan, 569-0801
        • Osaka Medical College
      • Toyonaka,Shibaharacho,4-14-1, Osaka, Japan, 560-0055
        • Toyonaka Municipal Hospital
    • Saitama
      • Kita-adachi,Ina,Komuro,818, Saitama, Japan, 362-0806
        • Saitama Cancer Center
      • Tokorozawa,Namiki,3-2, Saitama, Japan, 359-8513
        • National Defense Medical College
    • Sizuoka
      • Shizuoka,Aoi-ku,Kitaando,4-27-1, Sizuoka, Japan, 420-8527
        • Shizuoka General Hospital
    • Tokyo
      • Bunkyo-ku,Honkomagome,3-18-22, Tokyo, Japan, 113-8677
        • Tokyo Metropolitan Komagome Hospital
      • Bunkyo-ku,Yushima,1-5-45, Tokyo, Japan, 113-8519
        • Tokyo Medical and Dental University Hospital
      • Chuo-ku,Tsukiji,5-1-1, Tokyo, Japan, 104-0045
        • National Cancer Center Hospital
      • Koto-ku,Ariake,3-10-6, Tokyo, Japan, 135-8550
        • Cancer Institute Hospital
      • Shinjuku-ku,Toyama,1-21-1, Tokyo, Japan, 162-8655
        • International Medical Center of Japan
      • Sumida-ku,Koutoubashi,4-23-15, Tokyo, Japan, 130-8575
        • Tokyo Metropolitan Bokutoh Hospital
    • Toyama
      • Toyama,Nishinagae,2-2-78, Toyama, Japan, 930-8550
        • Toyama Prefectural Central Hospital
    • Wakayama
      • Wakayama,Kimiidera,811-1, Wakayama, Japan, 641-8510
        • Wakayama Medical University, School of Medicine
    • Yamagata
      • Yamagata,Aoyagi,1800, Yamagata, Japan, 990-2292
        • Yamagata Prefectural Central Hospital

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

20 years to 75 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

Preoperatively

  • Histologically proven adenocarcinoma
  • T2 or deeper lesion in the upper third of the stomach without involvement of the greater curvature or esophageal invasion, irrespective of the primary tumor location or existence of multiple foci
  • No distant metastasis, not linitis plastica ('Borrmann 4'), not stump carcinoma, no prior treatment for 364 Randomized trial for splenectomy gastric cancer
  • Sufficient organ function
  • Written informed consent.

Intra-operatively

  • T2/T3/T4 and N0/N1/N2, no tumor on the greater curvature, no direct invasion of the pancreas or spleen, negative peritoneal lavage cytology
  • No apparent nodal metastasis in the splenic hilum or along the splenic artery

Exclusion Criteria:

  • Liver cirrhosis or portal hypertension
  • Idiopathic thrombocytopenic purpura
  • Severe pulmonary dysfunction
  • Synchronous or metachronous (within 5 years) malignancy.

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

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: 1
Procedure/Surgery: Surgery: Splenectomy
Procedure/Surgery: Surgery: Splenectomy
Experimental: 2
Procedure/Surgery: Surgery: Spleen-preservation
Procedure/Surgery: Surgery: Spleen-preservation

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Overall survival
Time Frame: During the study conduct
During the study conduct

Secondary Outcome Measures

Outcome Measure
Time Frame
Post-operative morbidity
Time Frame: 5 years
5 years
operation time
Time Frame: day of the operation
day of the operation
perioperative blood loss
Time Frame: 3 days after operation
3 days after operation

Collaborators and Investigators

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

Sponsor

Investigators

  • Study Chair: Mitsuru Sasako, MD, PhD, Hyogo College of Medicine

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

June 1, 2002

Primary Completion (Actual)

March 1, 2014

Study Completion (Actual)

March 1, 2014

Study Registration Dates

First Submitted

May 27, 2005

First Submitted That Met QC Criteria

May 27, 2005

First Posted (Estimate)

May 30, 2005

Study Record Updates

Last Update Posted (Estimate)

September 22, 2016

Last Update Submitted That Met QC Criteria

September 20, 2016

Last Verified

September 1, 2016

More Information

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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