- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03955185
Clinical Trial of Minimally Invasive Surgery Versus Abdominal Surgery in Patients With Early Stage Cervical Cancer (RWS-01)
Clinical Trial of Minimally Invasive Surgery Versus Abdominal Surgery in Patients With Early Stage Cervical Cancer, A Multicenter, Prospective and Non-Randomized Controlled Trial
Cervical cancer is the most common cause of death from gynecological cancer world-wide. With technological innovation, minimally invasive or even non-invasive medical treatment has become a trend. Since the first cases of laparoscopic radical hysterectomy of cervical cancer have been reported in 1992, many single-center observational cohort studies have shown that compared to open abdominal surgery ,minimally invasive surgery (laparoscopic or robotic radical hysterectomy) showed advantages of less blood loss, shorter hospital stay and fewer intraoperative complications, while the 5-year survival and disease-free survival were similar. The NCCN guidelines and ESGO recommendations also clearly indicated that patients with FIGO stage IA2 -IIA cervical cancer could undergo open or laparoscopic/robotic radical hysterectomy. However, in October 2018, the results of two studies published in the《New England Journal of Medicine》have subverted our traditional perception of minimally invasive surgery and caused widespread controversy in the field of gynecologic oncology treatment. Both studies showed that the survival rate in the minimally invasive surgery group was lower than that in the open surgery group.
The results of these two studies have brought unprecedented doubts and challenges to the minimally invasive surgery for cervical cancer. The MD Anderson Cancer Center has even stopped minimally invasive surgery for cervical cancer. Several hospitals in Hong Kong have responded similarly. The NCCN guidelines are also quickly updated based on the results of those studies: patients should be informed of the results of this study and doctors should respect the patient's choices. The above research results have also attracted the attention of many gynecological oncologists in the mainland China. Some experts questioned the design of this study design as well as surgical skills. We need to look at these findings cautiously. So, we launched a real-world study of clinical outcomes affected by different surgical treatment for patients of early stage cervical cancer. We plan to recruit 2000 patients with early cervical cancer from 20-30 selected surgical centers nationwide and perform surgery on patients with qualified and experienced doctors.We will inform the patients current status of the study in detail, divide the patients into different observational group according to their choices on surgical methods. The patients will be followed up closely after surgery. We will compare the differences in clinical outcomes between the two surgical methods and conduct subgroup and stratified analysis. We hope that this study can truly reflect the actual status and clinical l level of early cervical cancer treatment in China, and provide a high level of clinical evidence for the treatment of cervical cancer in China .
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Ding Ma, MD;PHD
- Phone Number: +86-027-83662681
- Email: dma@tjh.tjmu.edu.cn
Study Locations
-
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Hubei
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Wuhan, Hubei, China, 430030
- Recruiting
- Tongji hospital, Tongji Medical College, Huazhong University of Science and Technology
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Contact:
- Ding Ma, MD,PHD
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients with FIGO stage (2018) IA1 (with lymph vascular space invasion), IA2, IB1, IB2 or IIA1 disease
- Preoperative histologically confirmed primary adenocarcinoma, squamous cell carcinoma or adenosquamous carcinoma of the uterine cervix
- Age ≤ 65 years old;
- Physical grading: Karnofsky score ≥ 60 points;
- Initial treatment;
- Voluntarily joined the study, signed informed consent, willing to comply, and cooperative with follow-up; (Note: The maximum diameter of the cervical lesion is subject to MRI measurements)
Exclusion Criteria for Preoperative Patients:
- Patients with contraindications to surgery;
- Patients who have previously received pelvic/abdominal radiation or chemotherapy;Patients who had received radiotherapy and chemotherapy for other cancers in the past.
- Patients with evidence of extra cervical metastases by CT, MRI or PET.
- Unable or unwilling to sign informed consent.
- Unable or unwilling to comply with research requirements.
- Patients with diameter of lymph node metastasis ≥ 2 cm by preoperative MRI.
- Patients with pregnancy.
- Patients requiring fertility-preserving surgery.
- Patients who had previously received subtotal hysterectomy.
- Patients participating in other clinical trials.
- Patients with other reasons not suitable clinical trials identified by researchers.
Exclusion Criteria for Postoperative Patients:
- Postoperative pathology: endometrioid adenocarcinoma, clear cell carcinoma, special type adenocarcinoma, neuroendocrine carcinoma (small cell carcinoma), tuberculosis.
- Postoperative tumor size ≥ 4 cm.
- Patients with abdominal aortic lymph node metastasis.
- Patients with severe postoperative complications that are not suitable for adjuvant therapy and affect patient follow-up.
- Patients who did not follow requirements for various reasons (except for various complications and deaths caused by tumor recurrence and metastasis).
- Situation which researchers believe that treatment should be terminated.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NON_RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Minimally invasive surgery
The patients will receive laparoscopic or robotic assisted radical hysterectomy with improved surgery details: 1) Uterine manipulator type Cup-shaped uterine manipulator is prohibited, uterus hanging wire is allowed.
2) Avoid tumor cells shedding into the pelvis: A. Cut the vagina with the transvaginal method, B. Cut the vagina after closed loop ligation of the vagina.
After the surgery, they will receive adjuvant therapy according to the pathological risk factors refer to the 2018 NCCN guidelines.
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Laparoscopic or robotic assisted radical hysterectomy
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ACTIVE_COMPARATOR: Open abdominal surgery
The patients will receive traditional radical hysterectomy.After the surgery, they will receive adjuvant therapy according to the pathological risk factors refer to the 2018 NCCN guidelines.
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Traditional open abdominal radical hysterectomy
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
disease-free survival (DFS) of 3 years and 5 years
Time Frame: up to 5 years
|
DFS was definite as the time from surgery to disease recurrence
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up to 5 years
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
overall survival (OS) of 3 years and 5 years
Time Frame: up to 5 years
|
OS was defined as time from surgery to death by any cause
|
up to 5 years
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Ding Ma, MD;PHD, Huazhong University of Science and Technology
Study record dates
Study Major Dates
Study Start (ACTUAL)
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
- RWS cervical cancer
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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.
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