- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03837782
Outcome of Resection for Colorectal Cancer (LRLCC)
Minimally Invasive Versus Abdominal Radical Resection for Colorectal Cancer
There are limited data from retrospective studies regarding whether short-term and long-term outcomes after laparoscopic or robot-assisted radical colectomy (minimally invasive surgery) are equivalent to those after open abdominal radical colectomy (open surgery) among patients with early and medium-stage colorectal cancer.
This trial is a multicenter,prospective, randomized trial evaluating short-term and survival outcomes concerning minimally invasive surgery and open surgery for colorectal cancer.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Radical colectomy and proctectomy with regional lymphadenectomy remain the standard recommendation for patients with early and medium-stage colorectal cancer. Current guidelines from the National Comprehensive Cancer Network indicate that either laparotomy (open surgery) or laparoscopy (minimally invasive surgery performed with either conventional or robotic techniques) is an acceptable approach to radical resection in patients with early- and medium stage (I to III) colorectal cancer. These recommendations have led to widespread use of a minimally invasive approach for radical resection, although there is a paucity of adequately powered, prospective, randomized trials evaluating short term and survival outcomes.
Retrospective studies involving patients with early and medium-stage colorectal cancer have shown that laparoscopic resection is associated with less intraoperative blood loss, a shorter length of hospital stay, and a lower risk of postoperative complications than open abdominal radical resection. Similarly, the minimally invasive approach has not been associated with lower 5-year rates of disease-free survival or overall survival than the open approach. In addition, retrospective studies have shown that recurrence rates and survival rates do not differ significantly between the two approaches.
The investigators hypothesized that minimally invasive surgery was not inferior or superior to open radical resection in terms of short-term and long-term outcome. In the present trial, the Laparoscopic Resection and Laparotomy for Colorectal Cancer (LRLCC) Trial, the investigators tested this hypothesis by prospectively assigning patients to minimally invasive (conventional laparoscopic or robotic) or open abdominal radical surgery and comparing the short-term outcome, the rate of recurrence, and the overall survival rate between the two groups.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Tianjin
-
Tianjin, Tianjin, China, 300060
- Tianjin Medical University Cancer Institute and Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
(i) tumor without distant metastasis; (ii) classified as stage I, II or III by TNM staging system; (iii) Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 or 1; (iv) a minimum of 12 lymph nodes resected to accurately identify stage; (v) solitary malignant lesion after thorough colonoscopy; (vi) complete resection (R0) with no positive nodes left behind; (vii) histological diagnosis of adenocarcinoma.
Exclusion Criteria:
(i) <18 years or >90 years; (ii) serious concurrent illness; (iii) clinically suspicious distant metastasis detected by positron emission tomography-computed tomography (PET-CT); (iv) familial adenomatous polyposis syndrome (FAP), hereditary non-polyposis colorectal cancer (HNPCC) and other hereditary CRC; (v) postoperative pathological close, indeterminate, or positive margins; (vi) circumferential resection margin < 1mm in rectal cancer; (vii) short anticipated life expectancy due to postoperative comorbidities on account of cardiopulmonary insufficiency.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: minimally invasive surgery
Patients were randomized to undergo minimally invasive radical resection (endoscopic surgery or robotic assisted surgery). Each participating site required accreditation by the trial management committee to ensure proper surgical technique during minimally invasive surgery. Patients were eligible if they had colorectal adenocarcinoma; had a disease stage of I (T1,T2), IIABC (T3-T4ab) or IIIABC (TanyN1-2) according to the staging system of NCCN; and had an Eastern Cooperative Oncology Group (ECOG) performance-status score of 0 or 1 (on a 5-point scale, with higher values indicating greater disability). |
Each participating site required accreditation by the trial management committee to ensure proper surgical technique during minimally invasive surgery.
No individual surgeons performed only the open approach or only the minimally invasive approach.
The committee members reviewed the patients' outcomes and the videos to ensure the adequacy of the surgeon's technique.
|
No Intervention: open surgery
Patients were randomized to undergo open radical resection (laparotomy). Each participating site required accreditation by the trial management committee to ensure proper surgical technique during minimally invasive surgery. Patients were eligible if they had colorectal adenocarcinoma; had a disease stage of I (T1,T2), IIABC (T3-T4ab) or IIIABC (TanyN1-2) according to the staging system of NCCN; and had an Eastern Cooperative Oncology Group (ECOG) performance-status score of 0 or 1 (on a 5-point scale, with higher values indicating greater disability). Exclusion criteria included a history of abdominal or pelvic radiotherapy, or evidence of metastatic disease on positron-emission tomography-computed tomography, magnetic resonance imaging, or computed tomography. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
complications
Time Frame: through hospital stay, an average of two weeks
|
complications includes intraoperative and postoperative complications, such as huge blood loss, anastomotic fistula, abdominal infection and septic shock.
|
through hospital stay, an average of two weeks
|
disease free survival
Time Frame: From date of randomization until the date of first documented progression, assessed up to 70 months
|
Disease-free survival (DFS) was defined as the interval between the date of surgical resection and diagnosis of recurrence or the most recent follow-up date.
|
From date of randomization until the date of first documented progression, assessed up to 70 months
|
overall survival
Time Frame: From date of randomization until the date of death from any cause, assessed up to 70 months.
|
Overall survival (OS) was measured from the date of hepatectomy to death with or without HCC recurrence or the end of this study period.
|
From date of randomization until the date of death from any cause, assessed up to 70 months.
|
Collaborators and Investigators
Collaborators
Investigators
- Study Director: Dalu M Kong, M.D., Tianjin Medical University
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- LRLCC
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Laparoscopy
-
TakedaCompleted
-
Kangbuk Samsung HospitalUnknown
-
Kangbuk Samsung HospitalCompletedLaparoscopyKorea, Republic of
-
M.D. Anderson Cancer CenterTerminatedLaparoscopyUnited States
-
University Hospital, Strasbourg, FranceRecruiting
-
Capital Medical UniversityCompleted
-
Czech Technical University in PragueMilitary University Hospital, PragueCompleted
-
Marko KraljevicUniversity Hospital, Basel, SwitzerlandRecruiting
-
Kangbuk Samsung HospitalCompletedLaparoscopyKorea, Republic of
Clinical Trials on minimally invasive surgery
-
Istituto Clinico HumanitasFondazione Umberto VeronesiRecruiting
-
University of OuluRecruitingEndometriosis | Surgery | Deep EndometriosisFinland
-
National Taiwan University HospitalCompletedColorectal Cancer | AdhesionTaiwan
-
October 6 UniversityCompleted
-
Yarmouk UniversityCompletedMinimally Invasive Surgery | Hydatid Disease | Spleen-Preserving Surgery | Echinococcus Granulosus InfectionJordan
-
Hospital del MarEnrolling by invitationGallbladder CancerSpain
-
University of Illinois at ChicagoRecruiting
-
Yonsei UniversityRecruiting
-
Radboud University Medical CenterDutch Heart Foundation; Penumbra Inc.CompletedIntracerebral Hemorrhage | Surgical Procedures, Minimally InvasiveNetherlands
-
Associazione Italiana per lo Studio del PancreasRecruiting