Low Rectal Cancer Study (MERCURY II) (MERCURY II)

September 17, 2018 updated by: Royal Marsden NHS Foundation Trust

The Low Rectal Cancer Study.

The MERCURY Study demonstrated the accuracy, feasibility and reproducibility of Magnetic Resonance Imaging (MRI) to stage rectal cancer in a prospective, multidisciplinary, multi-centre study. However, there were differences in patient outcome, dependent upon the position of the tumour in the rectum and its height above the anal verge. Whilst the outcome was excellent for patients who underwent an anterior resection, the outcome, based upon margin involvement and quality of the specimen, was poor for patients who underwent an abdomino-perineal excision for low rectal cancer.

It is proposed that accurate MRI staging pre-operatively will allow the correct patients to receive neo-adjuvant chemoradiotherapy (CRT), and also pre-warn the surgeons if the resection margins appear threatened so that the operation can be modified to take this into account. The primary aims of the Low Rectal Cancer Study (MERCURY II) are to assess the rate of CRM positivity rate in low rectal cancer and to assess the difference in global quality of life at two years post surgery in patients according to plane of surgery with or without sphincter preservation.

Study Overview

Status

Unknown

Conditions

Detailed Description

The aim of this study is to reduce the positive margin rate of 30% to around 15%. The study is an international multicentre, prospective, observational study, whereby patients with biopsy-proven low-rectal cancer (lower edge of the tumour < 6cms from the anal verge on MRI), will be recruited from participating centres, having given informed, written consent. Data from the radiology, surgical and pathological aspects will be collected and analysed centrally at the Royal Marsden Hospital. The patient's medical records will be reviewed for five years post surgery, and the patients will also be followed up by quality of life questionnaires. This project aims to show that in low rectal cancer, improved local control and survival can be achieved through a reduction in the involved CRM rates by MRI-planned surgery and selective pre-operative therapy. It also aims to assess the ability to predict disease recurrence and to provide an assessment of disease-free survival and overall survival.

Study Type

Observational

Enrollment (Actual)

542

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

  • Germany
      • Berlin, Germany, 10249
        • Vivantes Klinikum im Friedrichshain
      • Dresden, Germany, 01067
        • Krankenhaus Dresden-Friedrichstadt
  • Serbia
      • Belgrade, Serbia, 11000
        • The First Surgical Clinic
  • United Kingdom
      • Belfast, United Kingdom, BT16 1RH
        • Ulster Hospital
      • London & Surrey, United Kingdom
        • Royal Marsden Hospital
      • Manchester, United Kingdom, M8 5RB
        • North Manchester General Hospital
    • Buckinghamshire
      • Milton Keynes, Buckinghamshire, United Kingdom, MK6 5LD
        • Milton Keynes General Hospital
    • Cheshire
      • Stockport, Cheshire, United Kingdom, SK2 7JE
        • Stepping Hill Hospital
    • Hampshire
      • Basingstoke, Hampshire, United Kingdom, RG24 9NA
        • North Hampshire Hospitals NHS Trust (Basingstoke Hospital)
    • Middlesex
      • Isleworth, Middlesex, United Kingdom, TW7 6AF
        • West Middlesex University Hospital
    • Somerset
      • Weston-super-Mare, Somerset, United Kingdom, BS23 4TQ
        • Weston General Hospital
    • Surrey
      • Croydon, Surrey, United Kingdom, CR7 7YE
        • Croydon University Hospital
      • Frimley, Surrey, United Kingdom, GU16 7UJ
        • Frimley Park Hospital NHS Foundation Trust
    • Wales
      • Bridgend, Wales, United Kingdom, CF31 1RQ
        • Princess of Wales Hospital
      • Cardiff, Wales, United Kingdom, CF14 4XW
        • University Hospital of Wales
    • West Yorkshire
      • Bradford, West Yorkshire, United Kingdom, BD9 6RJ
        • Bradford Royal Infirmary
    • Wiltshire
      • Salisbury, Wiltshire, United Kingdom, SP2 8BJ
        • Salisbury NHS Foundation Trust (Salisbury District 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

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

Patients with biopsy proven adenocarcinoma within 6cm of the anal verge confirmed on MRI.

Description

Inclusion Criteria:

  • Ability to give informed, written consent.
  • Adults age 18 or over - male or female.
  • Recently diagnosed with biopsy-proven, primary, low rectal cancer.
  • No previous therapy for rectal cancer.

Exclusion Criteria:

  • Current pregnancy, including ectopic pregnancy.
  • Previous pelvic/rectal malignancy (excluding carcinoma in-situ).
  • Previous pelvic radiotherapy.
  • Previous pelvic floor surgery for faecal incontinence or prolapse.

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

  • Observational Models: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Staging and outcomes for patients with Low Rectal Cancer
Low Rectal Cancer defined on MRI as a cancer within 6cm of the anal verge

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
To assess the rate of CRM positivity rate in low rectal cancer.
Time Frame: 4 years
4 years
To compare global quality of life at two years post surgery in patients according to plane of surgery with or without sphincter preservation.
Time Frame: 8 years
8 years

Secondary Outcome Measures

Outcome Measure
Time Frame
To compare patient reported outcomes in patients according to plane of surgery with or without sphincter preservation.
Time Frame: 8 years
8 years
Analysis of the clinical and radiological factors influencing the decision by surgeons to carry out Anterior Resections, APE or extralevator APE.
Time Frame: 8 years
8 years
Comparison of time to local recurrence, disease-free and overall survival between patients undergoing different types of surgery.
Time Frame: 8 years
8 years
Comparison of imaging and pathology staging assessment, patient characteristics and complication rates, between different types of surgery and surgical approaches.
Time Frame: 8 years
8 years
Investigation of potential associations between imaging and pathology assessment of radial and distal margins, neo-adjuvant chemoradiotherapy, perineal complications and sphincter preservation rates.
Time Frame: 8 years
8 years
Investigation of potential association between length of operation with number of complications and length of post-operative ITU/HDU stay.
Time Frame: 8 years
8 years

Collaborators and Investigators

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

Sponsor

Royal Marsden NHS Foundation Trust

Collaborators

Pelican Cancer Foundation

Investigators

  • Principal Investigator: Gina Brown, Royal Marsden NHS Foundation Trust
  • Principal Investigator: Brendan Moran, Pelican Cancer Foundation

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.

General Publications

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 (Actual)

August 13, 2007

Primary Completion (Actual)

March 11, 2016

Study Completion (Anticipated)

March 11, 2021

Study Registration Dates

First Submitted

November 21, 2013

First Submitted That Met QC Criteria

December 4, 2013

First Posted (Estimate)

December 9, 2013

Study Record Updates

Last Update Posted (Actual)

September 18, 2018

Last Update Submitted That Met QC Criteria

September 17, 2018

Last Verified

September 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CCR2943

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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