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Fragilidade, qualidade de vida e reversão precoce do estoma desfuncional temporário no câncer de ovário (FOLERO)

25 de setembro de 2026 atualizado por: Sahar Salehi

Fragilidade, qualidade de vida e reversão precoce do estoma desfuncional temporário no câncer de ovário (FOLERO): um estudo de coorte prospectivo para determinar o efeito da fragilidade na sobrevivência e avaliar a reversão precoce do estoma intestinal temporário

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.

Visão geral do estudo

Status

Recrutamento

Condições

Intervenção / Tratamento

Descrição detalhada

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 de estudo

Intervencional

Inscrição (Estimado)

475

Estágio

  • Não aplicável

Contactos e Locais

Esta seção fornece os detalhes de contato para aqueles que conduzem o estudo e informações sobre onde este estudo está sendo realizado.

Contato de estudo

Locais de estudo

  • Suécia
      • Gothenburg, Suécia, 41685
        • Recrutamento
        • Sahlgrenska University Hospital and Sahlgrenska Academy
        • Contato:
        • Investigador principal:
          • Pernilla Dahm-Kähler, MD, Prof.
        • Investigador principal:
          • Charlotte Palmqvist, MD, PhD
      • Linköping, Suécia, 581 85
      • Lund, Suécia, 22185
        • Recrutamento
        • Skåne University Hospital
        • Contato:
        • Investigador principal:
          • Mihaela Asp, MD, PhD
        • Subinvestigador:
          • Päivi Kannisto, MD, Ass Prof
    • Solna

Critérios de participação

Os pesquisadores procuram pessoas que se encaixem em uma determinada descrição, chamada de critérios de elegibilidade. Alguns exemplos desses critérios são a condição geral de saúde de uma pessoa ou tratamentos anteriores.

Critérios de elegibilidade

Idades elegíveis para estudo

18 anos e mais velhos (Adulto, Adulto mais velho)

Aceita Voluntários Saudáveis

Não

Gêneros Elegíveis para o Estudo

Fêmea

Descrição

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

Plano de estudo

Esta seção fornece detalhes do plano de estudo, incluindo como o estudo é projetado e o que o estudo está medindo.

Como o estudo é projetado?

Detalhes do projeto

  • Finalidade Principal: Outro
  • Alocação: N / D
  • Modelo Intervencional: Atribuição de grupo único
  • Mascaramento: Nenhum (rótulo aberto)

Armas e Intervenções

Grupo de Participantes / Braço
Intervenção / Tratamento
Experimental: Frailty

Single arm study evaluating frailty by assessment of questionnaires and three different frailty tools
Outro: Frailty and Quality of Life evaluation

Frailty and Quality of Life evaluation after surgery

O que o estudo está medindo?

Medidas de resultados primários

Medida de resultado
Descrição da medida
Prazo
Overall Survival
Prazo: 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

Medidas de resultados secundários

Medida de resultado
Descrição da medida
Prazo
1-year mortality
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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)
Prazo: 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
Prazo: 30 days after index surgery

Assessed by validated instruments, Clavien-Dindo Classification
30 days after index surgery
Readmissions
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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
Prazo: 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

Colaboradores e Investigadores

É aqui que você encontrará pessoas e organizações envolvidas com este estudo.

Patrocinador

Sahar Salehi

Investigadores

  • Diretor de estudo: Sahar Salehi, MD, PhD, Karolinska University Hospital

Publicações e links úteis

A pessoa responsável por inserir informações sobre o estudo fornece voluntariamente essas publicações. Estes podem ser sobre qualquer coisa relacionada ao estudo.

Publicações Gerais

Datas de registro do estudo

Essas datas acompanham o progresso do registro do estudo e os envios de resumo dos resultados para ClinicalTrials.gov. Os registros do estudo e os resultados relatados são revisados ​​pela National Library of Medicine (NLM) para garantir que atendam aos padrões específicos de controle de qualidade antes de serem publicados no site público.

Datas Principais do Estudo

Início do estudo (Real)

11 de março de 2024

Conclusão Primária (Estimado)

28 de março de 2030

Conclusão do estudo (Estimado)

28 de março de 2031

Datas de inscrição no estudo

Enviado pela primeira vez

26 de fevereiro de 2024

Enviado pela primeira vez que atendeu aos critérios de CQ

1 de março de 2024

Primeira postagem (Real)

7 de março de 2024

Atualizações de registro de estudo

Última Atualização Postada (Real)

28 de setembro de 2026

Última atualização enviada que atendeu aos critérios de controle de qualidade

25 de setembro de 2026

Última verificação

1 de setembro de 2026

Mais Informações

Termos relacionados a este estudo

Termos MeSH relevantes adicionais

Outros números de identificação do estudo

  • 2023-04696-01
  • 2023 (Concessão/Contrato do NIH dos EUA)

Informações sobre medicamentos e dispositivos, documentos de estudo

Estuda um medicamento regulamentado pela FDA dos EUA

Não

Estuda um produto de dispositivo regulamentado pela FDA dos EUA

Não

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