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Fragilità, qualità della vita e inversione precoce della stomia temporanea defunzionante nel cancro ovarico (FOLERO)

25 settembre 2026 aggiornato da: Sahar Salehi

Fragilità, qualità della vita e inversione precoce della stomia temporanea defunzionante nel cancro ovarico (FOLERO): uno studio prospettico di coorte per determinare l'effetto della fragilità sulla sopravvivenza e valutare l'inversione precoce della stomia intestinale temporanea

Complete macroscopic surgical resection (CMR) requires extensive surgery and combined with chemotherapy confers best chance of survival in advanced ovarian cancer. During cytoreductive surgery 11% of women require a temporary diverting intestinal stoma.

Unexpectedly, our results from a unique fully accounted for population demonstrate that survival was not improved when increasing the proportion of women in whom CMR was achieved and in a yet unidentified subgroup of women extensive surgery was detrimental. In these women surgical treatment should be omitted in favor of chemotherapy only. Accordingly, there is an imperative need to improve patient selection to surgical treatment.

In Sweden, we treat an unselected population of women in a public healthcare system, where 30% of women with are >75 years. Despite these circumstances guidelines on patient-selection are lacking.

Age is an imprecise variable to base clinical decisions on but must be considered with an aging population. The dynamics between physiological changes of aging, comorbidity and medical condition are included in the concept of frailty, that has gained little attention in oncology, despite their potential to stratify risk and mortality.

The FOLERO study is a prospective adequately powered national cohort study with aim to determine if frailty instruments may be used to select patient to surgical treatment. In addition, we test the feasibility of early stoma reversal after index cytoreductive surgery in a small phase I trial and follow our patients Health Related Quality of Life after state of the art surgical treatment.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Hypothesis: Frailty is a predictor of poor survival Primary objective: To assess three different frailty instruments as predictors of survival Exposure: Frailty according to the three different frailty instruments evaluated Control: No frailty according to the three different frailty instruments evaluated Primary outcome measure: Overall survival

Secondary objectives (selection):

  • To evaluate the effect of sarcopenia on postoperative outcome and survival
  • To evaluate the effect of surgical extent on postoperative outcome and survival
  • To describe the HRQoL and symptoms of the" Low anterior resection syndrome" after surgery

Phase I sub-study on the feasibility and safety of early stoma reversal (Karolinska University Hospital only)

Hypothesis: Early stoma reversal in select patients with advanced ovarian cancer is feasible and safe.

Primary objective: To assess the feasibility and safety of early closure of defunctioning stoma after upfront cytoreductive surgery in ovarian cancer Primary outcome measure : Feasibility and safety of early stoma reversal as measured by rate of anastomotic leakage, urgent re- operations and time-interval to adjuvant chemotherapy (defined cut-offs based on historic comparison in the study protocol)

Tipo di studio

Interventistico

Iscrizione (Stimato)

475

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Luoghi di studio

      • Gothenburg, Svezia, 41685
        • Reclutamento
        • Sahlgrenska University Hospital and Sahlgrenska Academy
        • Contatto:
        • Investigatore principale:
          • Pernilla Dahm-Kähler, MD, Prof.
        • Investigatore principale:
          • Charlotte Palmqvist, MD, PhD
      • Linköping, Svezia, 581 85
      • Lund, Svezia, 22185
        • Reclutamento
        • Skåne University Hospital
        • Contatto:
        • Investigatore principale:
          • Mihaela Asp, MD, PhD
        • Sub-investigatore:
          • Päivi Kannisto, MD, Ass Prof
    • Solna

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

18 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Femmina

Descrizione

Inclusion Criteria:

  • Women with epithelial ovarian cancer scheduled for cytoreductive surgery with curative intent
  • Age ≥18 years
  • Signed written informed consent

Exclusion Criteria:

  • Not able to understand the Swedish or English language
  • Other diagnosis than ovarian cancer on final pathology

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Altro
  • Assegnazione: N / A
  • Modello interventistico: Assegnazione di gruppo singolo
  • Mascheramento: Nessuno (etichetta aperta)

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Sperimentale: Frailty

Single arm study evaluating frailty by assessment of questionnaires and three different frailty tools

Frailty and Quality of Life evaluation after surgery

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Overall Survival
Lasso di tempo: 24 months after index surgery

Overall survival time is calculated from the date of index surgery to the date of death (due to any cause), or for patients still alive to the date of last follow-up.

24 months after index surgery

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
1-year mortality
Lasso di tempo: 12 months from index surgery

Mortality within 1-year after index surgery

12 months from index surgery
Health related quality of life (HRQoL) (QLQ-C30)
Lasso di tempo: At baseline, 12-15 weeks after index surgery and 12 months after index surgery

Assessed by validated questionnaire and comprise the European Organisation for Research and Treatment of Cancer (EORTC), Core Questionnaire (QLQ-C30)

At baseline, 12-15 weeks after index surgery and 12 months after index surgery
Health related quality of life (HRQoL) (QLQ-OV28)
Lasso di tempo: At baseline, 12-15 weeks after index surgery and 12 months after index surgery

Assessed by validated questionnaire and comprise the European Organisation for Research and Treatment of Cancer (EORTC), EORTC Quality of life Questionnaire Ovarian Cancer Module (QLQ)-OV28

At baseline, 12-15 weeks after index surgery and 12 months after index surgery
Health related quality of life (HRQoL) (QLQ-ELD14)
Lasso di tempo: At baseline, 12-15 weeks after index surgery and 12 months after index surgery

Assessed by validated questionnaire and comprise the European Organisation for Research and Treatment of Cancer (EORTC), EORTC Quality of life Questionnaire Elderly Module (EORTC-QLQ-ELD14)

At baseline, 12-15 weeks after index surgery and 12 months after index surgery
Health related quality of life (HRQoL) (EQ-5D-5L)
Lasso di tempo: At baseline, 12-15 weeks after index surgery and 12 months after index surgery

Assessed by validated questionnaire and comprise the European Organisation for Research and Treatment of Cancer (EORTC), EQ-5D-5L

At baseline, 12-15 weeks after index surgery and 12 months after index surgery
Low anterior resection syndrome (LARS)
Lasso di tempo: At baseline, 12-15 weeks after index surgery and 12 months after index surgery

Assessed by the validated LARS questionnaire

At baseline, 12-15 weeks after index surgery and 12 months after index surgery
Postoperative complications
Lasso di tempo: 30 days after index surgery

Assessed by validated instruments, Clavien-Dindo Classification

30 days after index surgery
Readmissions
Lasso di tempo: 30 days after index surgery

Assessed by review of hospital records from the day of discharge after index surgery

30 days after index surgery
Length of hospital stay
Lasso di tempo: From date of index surgery to the date of discharge or at latest 90 days after index surgery

Assessed by review of hospital records

From date of index surgery to the date of discharge or at latest 90 days after index surgery
Extent of surgery vs survival
Lasso di tempo: Up to 60 months after index surgery

Measured by surgical complexity score (as defined by the Mayo and Karolinska Surgical Complexity scores) and Peritoneal Cancer Index (PCI) both by assessment at the preoperative multidisciplinary conference

The agreement between preoperative and peroperative assessment of surgical extent needed to achive complete macroscopic resection.

Up to 60 months after index surgery
Sarcopenia vs post-operative outcome
Lasso di tempo: Up to 60 months after index surgery

Sarcopenia is measured by computed tomography and different muscle groups by different software programs (e.g. Coreslicer, Slice-o-matic etc.).

Up to 60 months after index surgery
Standard regimen of adjuvant chemotherapy
Lasso di tempo: At 1 year after index surgery

Standard regimen of adjuvant chemotherapy is defined as Carboplatin (AUC 5) and Paclitaxel (175 mg/m2) every 21 days for 6 cycles. Dose and frequency will be assessed by review of hospital records

At 1 year after index surgery
Time interval to adjuvant chemotherapy
Lasso di tempo: From index surgery to first infusion of adjuvant chemotherapy

Assessed by review of hospital records.

From index surgery to first infusion of adjuvant chemotherapy
Total number of hospital days and readmissions within90 days after index surgery
Lasso di tempo: 90 days after index surgery

Total number of hospital days within 90 days after index surgery by review of hospital records

90 days after index surgery
Health economics
Lasso di tempo: At baseline, 12-15 weeks after index surgery and 1 year after index surgery

Health economics will be assessed by the Eq5D-5L validated instrument

At baseline, 12-15 weeks after index surgery and 1 year after index surgery
Recurrence or progression free survival
Lasso di tempo: Up to 60 months after index surgery

Defined as the time interval between index surgery and the date of recurrence or death, whichever comes first. For event-free patients recurrence free survival is the time between index surgery and the date for the last follow-up visit by review of medical records.

Up to 60 months after index surgery

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

  • Direttore dello studio: Sahar Salehi, MD, PhD, Karolinska University Hospital

Pubblicazioni e link utili

La persona responsabile dell'inserimento delle informazioni sullo studio fornisce volontariamente queste pubblicazioni. Questi possono riguardare qualsiasi cosa relativa allo studio.

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

11 marzo 2024

Completamento primario (Stimato)

28 marzo 2030

Completamento dello studio (Stimato)

28 marzo 2031

Date di iscrizione allo studio

Primo inviato

26 febbraio 2024

Primo inviato che soddisfa i criteri di controllo qualità

1 marzo 2024

Primo Inserito (Effettivo)

7 marzo 2024

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

28 settembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

25 settembre 2026

Ultimo verificato

1 settembre 2026

Maggiori informazioni

Termini relativi a questo studio

Altri numeri di identificazione dello studio

  • 2023-04696-01
  • 2023 (Sovvenzione/contratto NIH degli Stati Uniti)

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .