- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04364373
D2 vs D3 Lymph Node Dissection for Left Colon Cancer (DILEMMA)
D2 vs D3 Lymph Node Dissection for Left Colon Cancer: Multicenter Randomize Control Trial (DILEMMA)
Study Overview
Status
Conditions
Detailed Description
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Vladimir Balaban, Ph.D
- Phone Number: +79889478358
- Email: balaban@kkmx.ru
Study Contact Backup
- Name: Inna Tulina, Ph.D
- Phone Number: +79264086672
- Email: tulina@kkmx.ru
Study Locations
-
-
-
Moscow, Russian Federation, 119435
- Recruiting
- Clinic of coloproctology and minimally invasive surgery
-
Contact:
- Vladimir Balaban, Ph.D
- Phone Number: +79889478358
- Email: balaban@kkmx.ru
-
Contact:
- Inna Tulina, Ph.D
- Phone Number: +79264086672
- Email: tulina@kkmx.ru
-
Sub-Investigator:
- Mihail Mutyk
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Agreement of the patient to participate in trial
- Colon cancer (only adenocarcinoma )
- The tumor located between the splenic flexure and rectosigmoid junction
- cT3-Т4а,b
- cN0-2
- cM0
- Tolerance of chemotherapy
- ASA 1-3
Exclusion Criteria:
- сТis - Т2, сТ4b (tail of the pancreas, stomach, small bowel, ureter, urinary bladder)
- Preoperative complications of the tumor (perforation and full bowel 3. obstruction)
- Previous radiotherapy or chemotherapy
- Synchronous or metachronous tumors
- Women during Pregnancy or breast feeding period
Study Plan
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: D2 lymph node dissection
For tumours in splenic flexure and proximal and mid part of descending colon lymph nodes 232 and 231 will be removed. For tumours in distal part of descending colon and proximal sigmoid lymph nodes 231, 232 and partially 241, 242 (considering variation of the feeding artery) will be removed. For tumours in the mid part of sigmoid colon lymph nodes 241, 242 will be removed. For tumours in the rectosigmoid junction 251, 252 groups of the lymph node will be removed. |
This procedure is performed for tumours in splenic flexure and proximal and descending colon. Left colic artery is divided at its origin. Sigmoid arteries and superior rectal arteries are preserved. Inferior mesenteric vein is divided at the lower border of the pancreas. The colon is divided about 10 cm proximal and distal to the tumour. Mesocolic fascia is preserved and the length of the "vessel trunk" of the mesocolon corresponds to the level of lymph node dissection. After removal of the resected colonic segment a handsewn or stapler end-to-end or side-to-side colonic anastomosis is performed.
This procedure is performed for tumours in sigmoid colon.
Corresponding sigmoid arteries are divided at their origin.
Left colic artery and superior rectal artery are preserved.
Inferior mesenteric vein is divide close to the left colic artery.
Proximal and distal margin compose 10 cm from the tumour.
Mesocolic fascia is preserved and the length of the "vessel trunk" of the mesocolon corresponds to the level of lymph nodes dissection.
After removal of the resected colonic segment a handsewn end-to-end or side-to-side or stapler colonic anastomosis is performed.
This procedure is performed for tumours in distal sigmoid colon or rectosigmoid junction.
Superior rectal artery is divided below the origin of left colic artery.
Left colic artery is preserved.
Inferior mesenteric vein is divide close to the left colic artery.
The colon is divided about 10 cm proximal and 5 cm distal to the tumour.
Mesocolic fascia is preserved and the length of the "vessel trunk" of the mesocolon corresponds to the level of lymph node dissection.
After removal of the resected colonic segment handsewn or stapler colo-rectal anastomosis is performed.
|
Experimental: D3 lymph node dissection
For tumours in splenic flexure and proximal and mid part of descending colon lymph nodes 232, 231 and 253 will be removed. For tumours in distal part of descending colon and proximal sigmoid lymph nodes 231, 232 and 253 and partially 241, 242 (considering variation of the feeding artery) will be removed. For tumours in the mid part of sigmoid colon lymph nodes 241, 242 and 253 will be removed. For tumours in the rectosigmoid junction 251, 252 and 253 groups of the lymph node will be removed. |
This procedure is performed for tumours in splenic flexure and proximal and descending colon. Left colic artery is divided at its origin. Sigmoid arteries and superior rectal arteries are preserved. Inferior mesenteric vein is divided at the lower border of the pancreas. The colon is divided about 10 cm proximal and distal to the tumour. Mesocolic fascia is preserved and the length of the "vessel trunk" of the mesocolon corresponds to the level of lymph node dissection. After removal of the resected colonic segment a handsewn or stapler end-to-end or side-to-side colonic anastomosis is performed.
This procedure is performed for tumours in sigmoid colon.
Corresponding sigmoid arteries are divided at their origin.
Left colic artery and superior rectal artery are preserved.
Inferior mesenteric vein is divide close to the left colic artery.
Proximal and distal margin compose 10 cm from the tumour.
Mesocolic fascia is preserved and the length of the "vessel trunk" of the mesocolon corresponds to the level of lymph nodes dissection.
After removal of the resected colonic segment a handsewn end-to-end or side-to-side or stapler colonic anastomosis is performed.
This procedure is performed for tumours in distal sigmoid colon or rectosigmoid junction.
Superior rectal artery is divided below the origin of left colic artery.
Left colic artery is preserved.
Inferior mesenteric vein is divide close to the left colic artery.
The colon is divided about 10 cm proximal and 5 cm distal to the tumour.
Mesocolic fascia is preserved and the length of the "vessel trunk" of the mesocolon corresponds to the level of lymph node dissection.
After removal of the resected colonic segment handsewn or stapler colo-rectal anastomosis is performed.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
5-year overall survival
Time Frame: Up to 5 years post-operatively
|
Probability to be alive measured in %, where 100% means that patients have a 100% probability to be alive and 0% means that patients have 0% probability to be alive
|
Up to 5 years post-operatively
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
5-year disease free survival
Time Frame: Up to 5 years post-operatively
|
Probability to be alive with no signs of local or distant recurrence measured in %, where 100% means that patients have a 100% probability to be alive with no signs of local or distant recurrence and 0% means that patients have 0% probability to be alive with no signs of local or distant recurrence
|
Up to 5 years post-operatively
|
Postoperative sexual dysfunction
Time Frame: Up to 1 year post-operatively
|
The rate of ejaculation problems in sexually active men and the rate of decreased vaginal lubricant production in sexually active women, measured in % from the total number of male/female patients
|
Up to 1 year post-operatively
|
Apical lymph node involvement rate
Time Frame: 1 month after surgery
|
The rate of lymph nodes 253 with metastatic cells among all lymph nodes 253, measured in %
|
1 month after surgery
|
Intraoperative complications rate
Time Frame: Day 0
|
The rate of any complications within the course of surgery
|
Day 0
|
Early postoperative complications rate
Time Frame: 1-30 days after surgery
|
The rate of surgical and infectious complications
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1-30 days after surgery
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Mortality
Time Frame: 0-30 days after surgery
|
The rate of death from all causes
|
0-30 days after surgery
|
Late postoperative complications rate
Time Frame: 30-180 days after surgery
|
The rate of surgical and infectious complications
|
30-180 days after surgery
|
Collaborators and Investigators
Collaborators
Investigators
- Study Director: Peter Tsarkov, Ph.D, I.M. Sechenov First Moscow State Medical University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
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
- 0002
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
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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