- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT07462663
SHAPE-ENDO: Multimodal Preoperativ Optimering hos Patienter med Fetma och Tidig Endometriecancer (SHAPE-ENDO)
SHAPE-ENDO (Semaglutid + Hormonell Behandling & Prehabilitering vid Endometriecancer): Prospektiv Observationsstudie för Metabol och Kirurgisk Optimering hos Patienter med Atypisk Endometriel Hyperplasi eller Tidig Endometriecancer och BMI ≥35.
SHAPE-ENDO är en prospektiv observationsstudie som genomförs vid Hospital Universitari de Bellvitge och utvärderar en multimodal förkirurgisk optimeringsstrategi för kvinnor med fetma (BMI ≥35) och atypisk endometriehyperplasi eller tidigstadie endometriecancer. Deltagarna får standardvårdinterventioner inklusive semaglutidterapi, levonorgestrel intrauterin spiral (med eller utan oral progestin), strukturerade närings- och träningsprogram samt schemalagd endometrieövervakning.
Studien syftar till att utvärdera om denna multimodala strategi förbättrar metabolisk hälsa, främjar viktnedgång och ökar behörigheten för minimalinvasiv kirurgi samtidigt som onkologisk säkerhet upprätthålls under optimeringsperioden.
Deltagarna följs upp i 6–12 månader med övervakning av antropometriska och metabola parametrar, histologiskt svar, livskvalitet och behandlingsföljsamhet. Alla interventioner är en del av rutinmässig klinisk vård. Resultaten från denna studie kan informera framtida jämförande prövningar som utvärderar metabola optimeringsstrategier hos patienter med fetma och tidigstadie endometriecancer.
Studieöversikt
Status
Betingelser
Intervention / Behandling
- Beteende: Dietetisk-Nutritionell intervention
- Beteende: Strukturerat tränings- och förberedelseprogram
- Procedur: Endometriel biopsi med eller utan hysteroskopi
- Procedur: Radiologisk övervakning (MRI och transvaginal ultraljud)
- Läkemedel: GLP-1 Receptor Agonist
- Enhet: Levonorgestrel IUD (Lng-IUD)
- Läkemedel: Oral Progestins
- Procedur: Standar upfront Surgery
Detaljerad beskrivning
Fetma är en viktig riskfaktor för endometriecancer och är associerad med ökad kirurgisk komplexitet, perioperativ morbiditet och minskad berättigande till minimalt invasiv kirurgi. Hos patienter med svår fetma påverkas dödligheten ofta av metaboliska komorbiditeter snarare än cancerprogression. Strategier som syftar till att förbättra metabolisk hälsa och funktionell status före operation kan därför ha viktiga kliniska implikationer.
Hormonella terapier såsom levonorgestrel-frisättande intrauterina enheter och systemiska progestiner används vanligtvis för sjukdomskontroll hos utvalda patienter med atypisk endometriehyperplasi eller tidigstadiet endometrioid karcinom. Parallellt har glukagon-liknande peptid-1 receptoragonister, inklusive semaglutid, visat betydande viktminskning och kardiometabola fördelar. Multimodala prehabiliteringsansatser som kombinerar farmakologisk terapi, näringsoptimering och strukturerade träningsprogram kan förbättra kirurgisk beredskap och övergripande hälsostatus.
SHAPE-ENDO är en prospektiv observationskohortstudie som genomförs vid Hospital Universitari de Bellvitge. Studien utvärderar en multimodal preoperativ optimeringsstrategi som inkluderar farmakologisk viktkontroll med semaglutid, hormonell endometriebehandling med levonorgestrel intrauterin enhet med eller utan orala progestiner, samt livsstilsinterventioner inklusive övervakad kostrådgivning och träningsprogram. Patienter genomgår schemalagd klinisk uppföljning med metabolisk övervakning, bildtagning och endometrieprovtagning enligt rutinmässig klinisk praxis.
Studien syftar till att utvärdera genomförbarheten och den kliniska effekten av denna multimodala optimeringsstrategi hos kvinnor med fetma och tidigstadiet endometriesjukdom. Utfall inkluderar metaboliska och antropometriska förändringar, histologiskt svar, livskvalitet och berättigande till minimalt invasiv kirurgi. Data samlas in via elektroniska medicinska journaler, laboratorietester, bildstudier och validerade patientrapporterade utfallsfrågeformulär. Studien är godkänd av den institutionella etikkommittén och involverar endast standardvårdinterventioner.
Studietyp
Inskrivning (Beräknad)
Fas
- Fas 4
Kontakter och platser
Studiekontakt
- Namn: Jorge Garcia Fernandez, MD
- Telefonnummer: +34 622595644
- E-post: jorgarciafernan@gmail.com
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Studera befolkning
Beskrivning
Inklusionskriterier:
- Kvinnor ≥18 år gamla.
- Histologiskt bekräftad Atypisk Endometriehyperplasi / EIN eller lågrisk endometrioid endometriecancer (G1-G2), begränsad till livmoderkroppen.
- Klassificerad som låg/mellanrisk enligt ESGO-ESTRO-ESP 2025; kirurgiska stadier IA1, IA2 eller IB.
- Negativ eller fokal LVSI (om tillgänglig).
- Molekylära undergrupper: POLEmut, p53wt, MMRd eller NSMP ER+.
- BMI ≥35 kg/m² vid inklusion.
- Accepterande av tillfällig konservativ behandling och förmåga att följa multimodal optimeringsstrategi.
- Förmåga att förstå och underteckna informerat samtycke.
Exklusionskriterier:
- FIGO-stadier IA3, IC, II eller högre.
- Positiv lymfovaskulär invasion.
- Högrisk molekylär: p53mut eller NSMP ER-negativ.
- Icke-endometrioida histologier (serös, klar cell, karcinosarkom, blandad, etc.).
- Metastaserad eller extrauterin sjukdom.
- Kontraindikation mot GLP-1RA eller progestogener.
- Tidigare pankreatit, MEN-2, medullär sköldkörtelcancer.
- Deltagande i annat farmakologiskt försök.
- Allt tillstånd som enligt utredarens bedömning försämrar säkerhet eller följsamhet.
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Ingen (Open Label)
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Aktiv komparator: Arm A - Standard Immediate Surgery
Participants randomized to the control arm will undergo standard immediate surgical treatment according to the institutional protocol of Hospital Universitari de Bellvitge. Surgery will usually include hysterectomy with bilateral salpingo-oophorectomy, sentinel lymph node assessment when indicated and feasible, and minimally invasive or robotic approach whenever technically possible according to clinical judgment. Intervention: Procedure/Surgery - Standard Immediate Surgery Standard surgical management according to institutional practice for atypical endometrial hyperplasia/endometrial intraepithelial neoplasia or early-stage low-risk endometrioid endometrial cancer. Perioperative outcomes, surgical approach, conversion to laparotomy, estimated blood loss, operative time, hospital stay, transfusion, sentinel lymph node detection, intraoperative complications, and 30-day postoperative complications graded according to Clavien-Dindo will be recorded. |
Standard surgical treatment according to the institutional protocol of Hospital Universitari de Bellvitge for atypical endometrial hyperplasia/endometrial intraepithelial neoplasia or early-stage low-risk endometrioid endometrial cancer.
Surgery will usually include hysterectomy with bilateral salpingo-oophorectomy, sentinel lymph node assessment when indicated and feasible, and a minimally invasive or robotic approach whenever technically possible according to clinical judgment.
Surgical approach, operative time, estimated blood loss, conversion to laparotomy, transfusion, hospital stay, intraoperative complications, 30-day postoperative complications, readmission, and sentinel lymph node detection will be recorded.
Andra namn:
|
|
Experimentell: Arm B - Experimental: SHAPE-ENDO Multimodal Strategy Before Surgery
Participants randomized to the experimental arm will receive the SHAPE-ENDO multimodal pre-surgical optimization strategy before surgery. The strategy includes semaglutide/Wegovy®, levonorgestrel-releasing intrauterine device/Mirena® with or without oral medroxyprogesterone acetate/Progevera®, structured nutritional intervention, adapted physical exercise, and scheduled oncologic surveillance. The strategy will last 28 weeks initially and may be extended up to 54 weeks if there is clinical, metabolic, or anthropometric benefit, adequate tolerance, and no tumor progression. Intervention: Drug - Semaglutide / Wegovy® Weekly subcutaneous semaglutide administered according to approved labeling, clinical indication, tolerance, and endocrinology assessment, with standard dose escalation up to the tolerated therapeutic dose. Dose, adherence, tolerability, adverse events, and reasons for dose modification or discontinuation will be recorded. Intervention: Device - Levonorgestrel-Releasing I |
Personligt hypokaloriskt dietprogram övervakat av det kliniska nutritionsteamet som en del av standardbehandling vid fetma och metabol sjukdom.
Programmet inkluderar kaloribegränsning baserad på basala metaboliska behov, med möjlighet till mycket lågkaloridiet (VLCD) i 4–6 veckor i utvalda fall.
Uppföljning sker vid regelbundna öppenvårdsbesök med registrering av vikt, BMI, midjeomfång och följsamhet.
Denna intervention är en del av rutinmässig klinisk vård och tilldelas inte experimentellt; utfall registreras prospektivt.
Andra namn:
Ett strukturerat fysiskt träningsprogram utformat för att förbättra funktionell kapacitet, aerob tolerans och kirurgisk lämplighet.
Programmet inkluderar övervakade eller halvövervakade veckovisa pass som kombinerar aerob träning och styrketräning, vanligtvis 3 pass per vecka i 30-45 minuter, anpassat till baslinjeprestation.
Interventionen är en del av den rutinmässiga kliniska vården för patienter med fetma som genomgår kirurgisk förberedelse och tilldelas inte experimentellt.
Data om följsamhet, tolerans och funktionella utfall samlas in prospektivt
Andra namn:
Schemalagd histologisk övervakning utförs vid baslinje och med uppföljningsintervall (vanligtvis 14 och 28-54 veckor) för att bedöma lokal tumörstatus, inklusive komplett respons, stabilitet eller progression.
Procedurer inkluderar endometriell biopsi på öppen vård med valfri hysteroskopi baserat på klinisk indikation.
Dessa utvärderingar ingår som en del av standard klinisk vård för patienter som behandlas konservativt för atypisk endometriel hyperplasi eller tidig endometrioid karcinom och tilldelas inte experimentellt.
Data registreras prospektivt för att bedöma sjukdomsutveckling och kirurgisk behörighet.
Andra namn:
Radiologisk utvärdering med bäcken-MRT och transvaginal ultraljud utförs som en del av rutinmässig klinisk vård för att bedöma livmodersjukdom, invasion i myometriet, status för adnexa och behandlingssvar.
Bildtagning utförs vanligtvis vid baslinjen för att bekräfta stadieindelning och under uppföljning när det är kliniskt indikerat.
Dessa bildtagningstekniker används enligt standardiserade kliniska riktlinjer och tilldelas inte experimentellt; resultaten samlas in prospektivt för att utvärdera sjukdomsstabilitet och kirurgisk planering.
Andra namn:
Weekly subcutaneous semaglutide/GLP-1 receptor agonist therapy administered according to approved labeling, clinical indication, patient tolerance, and endocrinology assessment, with standard dose escalation up to the tolerated therapeutic dose.
The intervention is used for weight loss and metabolic optimization in participants with severe obesity.
Dose, adherence, tolerability, and reasons for dose modification or discontinuation will be recorded prospectively.
Andra namn:
Local hormonal therapy using a 52-mg levonorgestrel-releasing intrauterine system placed at baseline or within 14 days after baseline, with ultrasound confirmation of correct placement.
The LNG-IUD is used within the protocolized SHAPE-ENDO strategy according to clinical indication, approved labeling, current guidelines, and physician judgment, for local disease control in atypical endometrial hyperplasia/endometrial intraepithelial neoplasia or early-stage, low-risk endometrioid endometrial cancer.
Tolerability, continuation, adverse events, and local histological response will be recorded prospectively.
Andra namn:
Systemic hormonal therapy prescribed according to clinical criteria to support local disease control in atypical endometrial hyperplasia or early-stage endometrioid carcinoma.
Typical regimens include medroxyprogesterone acetate (400-600 mg/day) or megestrol acetate (160-320 mg/day).
Therapy is initiated or escalated when indicated based on tumor burden or suboptimal response to LNG-IUD.
Oral progestins may be used within the protocolized SHAPE-ENDO strategy according to clinical indication, approved labeling, current guidelines, and physician judgment.
Use, dosing, tolerance, and outcomes will be recorded prospectively.
Andra namn:
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Recruitment Rate
Tidsram: From study opening to end of recruitment, up to 36 months.
|
Number of participants enrolled per month during the active recruitment period.
This outcome will assess the feasibility of recruiting eligible participants with atypical endometrial hyperplasia/endometrial intraepithelial neoplasia or low-risk endometrioid endometrial cancer and BMI ≥40 kg/m² into a pilot randomized clinical trial.
|
From study opening to end of recruitment, up to 36 months.
|
|
Acceptance of Randomization Rate
Tidsram: At baseline, before randomization.
|
Proportion of eligible participants who agree to participate in the trial and accept random assignment to either standard immediate surgery or the SHAPE-ENDO multimodal pre-surgical optimization strategy.
|
At baseline, before randomization.
|
|
Participant Retention Rate
Tidsram: From randomization to surgery and 30 days postoperatively, up to 14 months.
|
Proportion of randomized participants who complete the planned follow-up required for the main pilot analysis, including surgical treatment and 30-day postoperative assessment, or completion of the assigned intervention period when applicable.
|
From randomization to surgery and 30 days postoperatively, up to 14 months.
|
|
Adherence to the Assigned Intervention
Tidsram: From randomization to surgery and 30 days postoperatively, up to 14 months.
|
Proportion of randomized participants who comply with the main procedures planned in their assigned arm.
In the control arm, this includes undergoing standard immediate surgery and postoperative follow-up.
In the SHAPE-ENDO arm, this includes adherence to the multimodal strategy, scheduled visits, oncologic surveillance, and planned reassessment.
|
From randomization to surgery and 30 days postoperatively, up to 14 months.
|
|
Completion of the SHAPE-ENDO Multimodal Strategy
Tidsram: From randomization to week 28 or week 54.
|
Proportion of participants randomized to the SHAPE-ENDO arm who complete the planned multimodal pre-surgical optimization strategy until the week 28 reassessment and, when applicable, until week 54.
|
From randomization to week 28 or week 54.
|
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Proportion of SHAPE-ENDO Participants Reaching Surgery Without Tumor Progression
Tidsram: From randomization to surgery, up to 54 weeks.
|
Proportion of participants randomized to the SHAPE-ENDO arm who undergo surgery after the pre-surgical optimization period without histological, radiological, or clinical evidence of tumor progression.
|
From randomization to surgery, up to 54 weeks.
|
|
Incidence of Serious Adverse Events, Tumor Progression, and Study Discontinuation
Tidsram: From randomization to surgery and 30 days postoperatively, up to 14 months.
|
Frequency of serious adverse events, tumor progression during the optimization period, and reasons for discontinuation or withdrawal from the study.
Adverse events will be recorded prospectively and classified according to CTCAE v5.0 when applicable.
These events will be described overall and by randomized arm when applicable.
|
From randomization to surgery and 30 days postoperatively, up to 14 months.
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Perioperative Morbidity
Tidsram: At surgery and up to 30 days postoperatively.
|
Proportion of participants with intraoperative complications and/or clinically relevant postoperative complications within 30 days after surgery, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
Postoperative complications will be classified according to the Clavien-Dindo classification, with clinically relevant complications defined as Clavien-Dindo grade ≥II
|
At surgery and up to 30 days postoperatively.
|
|
Surgical Approach
Tidsram: At surgery.
|
Proportion of participants undergoing minimally invasive surgery, robotic surgery, conventional laparoscopy, or laparotomy, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
|
At surgery.
|
|
Conversion to Laparotomy
Tidsram: At surgery.
|
Proportion of participants requiring conversion from minimally invasive surgery to laparotomy, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
|
At surgery.
|
|
Operative Time
Tidsram: At surgery.
|
Duration of surgery measured in minutes, from skin incision to skin closure, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
|
At surgery.
|
|
Estimated Blood Loss
Tidsram: At surgery.
|
Estimated intraoperative blood loss measured in milliliters, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
|
At surgery.
|
|
Length of Hospital Stay
Tidsram: From surgery to hospital discharge, up to 30 days.
|
Number of days from surgery to hospital discharge, compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
|
From surgery to hospital discharge, up to 30 days.
|
|
Need for Blood Transfusion
Tidsram: At surgery and up to 30 days postoperatively.
|
Proportion of participants requiring perioperative blood transfusion, compared between the standard immediate surgery arm and the SHAPE-ENDO arm
|
At surgery and up to 30 days postoperatively.
|
|
Sentinel Lymph Node Detection Rate
Tidsram: At surgery.
|
Proportion of participants in whom sentinel lymph node mapping is successful, including unilateral and bilateral detection rates when sentinel lymph node assessment is performed.
Detection rates will be described and compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
|
At surgery.
|
|
Histological Response in the SHAPE-ENDO Arm
Tidsram: Baseline to week 14, week 28, and, if applicable, week 54.
|
Proportion of participants in the SHAPE-ENDO arm with complete response, stable disease, or tumor progression during the pre-surgical optimization period.
Complete response is defined as absence of endometrioid carcinoma or atypical hyperplasia in endometrial biopsy.
Stable disease is defined as persistence of the lesion without progression in grade or stage.
Progression is defined as progression from atypical endometrial hyperplasia/endometrial intraepithelial neoplasia to endometrioid endometrial carcinoma, increase to grade 3, high-risk histology, or extension beyond the uterine corpus.
|
Baseline to week 14, week 28, and, if applicable, week 54.
|
|
Time to Optimization in the SHAPE-ENDO Arm
Tidsram: From randomization to week 28 or week 54
|
Time from randomization to multidisciplinary committee decision indicating that sufficient clinical, metabolic, anthropometric, and oncologic optimization has been achieved to proceed to surgery.
|
From randomization to week 28 or week 54
|
|
Rate of Surgery After SHAPE-ENDO Optimization
Tidsram: From randomization to surgery, up to 54 weeks.
|
Proportion of participants randomized to the SHAPE-ENDO arm who undergo surgery after the pre-surgical optimization strategy.
|
From randomization to surgery, up to 54 weeks.
|
|
Change in Glycated Hemoglobin
Tidsram: Baseline to 6 months and baseline to 12 months.
|
Change from baseline in glycated hemoglobin, measured as HbA1c percentage using standard clinical laboratory assays.
Changes over time will be described within each arm and compared between the standard immediate surgery arm and the SHAPE-ENDO arm.
|
Baseline to 6 months and baseline to 12 months.
|
|
Change in Fasting Plasma Glucose
Tidsram: Baseline to 6 months and baseline to 12 months.
|
Change from baseline in fasting plasma glucose concentration, measured in mg/dL using standard laboratory assays.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months and baseline to 12 months.
|
|
Change in Insulinemia and HOMA-IR
Tidsram: Baseline to 6 months and baseline to 12 months.
|
Change from baseline in fasting insulin concentration and HOMA-IR, when available.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months and baseline to 12 months.
|
|
Change in FIB-4 Index
Tidsram: Baseline to 6 months and baseline to 12 months.
|
Change from baseline in fibrosis-4 index, calculated using age, AST, ALT, and platelet count.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months and baseline to 12 months.
|
|
Change in Lipid Profile
Tidsram: Baseline to 6 months and baseline to 12 months.
|
Change from baseline in triglycerides, LDL cholesterol, and HDL cholesterol measured using standard laboratory lipid panel testing.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months and baseline to 12 months.
|
|
Change in Blood Pressure
Tidsram: Baseline to 6 months and baseline to 12 months.
|
Change from baseline in systolic and diastolic blood pressure, measured in mmHg during scheduled clinical visits.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months and baseline to 12 months.
|
|
Change in C-Reactive Protein
Tidsram: Baseline to 6 months and baseline to 12 months.
|
Change from baseline in serum C-reactive protein concentration, measured in mg/L using standard laboratory assays.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months and baseline to 12 months.
|
|
Change in Body Weight and BMI
Tidsram: Baseline to 6 months and baseline to 12 months.
|
Absolute and percentage change from baseline in body weight and body mass index.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months and baseline to 12 months.
|
|
Change in Waist Circumference
Tidsram: Baseline to 6 months and baseline to 12 months.
|
Change from baseline in waist circumference, measured in centimeters.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months and baseline to 12 months.
|
|
Change in Visceral Adiposity by MRI
Tidsram: Baseline to week 28 and, if applicable, week 54.
|
Absolute and percentage change from baseline in visceral adiposity measured by pelvic MRI according to the predefined radiologic measurement protocol.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to week 28 and, if applicable, week 54.
|
|
Change in Body Composition by Bioelectrical Impedance Analysis
Tidsram: Baseline to week 28 and, if applicable, week 54.
|
Change from baseline in body composition parameters measured by bioelectrical impedance analysis.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to week 28 and, if applicable, week 54.
|
|
Change in Health-Related Quality of Life Score - SF-36
Tidsram: Baseline to 6 months, 12 months, and during long-term follow-up up to 5 years.
|
Change from baseline in health-related quality of life assessed using the Short Form-36 Health Survey.
Scores range from 0 to 100, with higher scores indicating better health-related quality of life.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months, 12 months, and during long-term follow-up up to 5 years.
|
|
Change in Quality of Life Score - EORTC QLQ-C30
Tidsram: Baseline to 6 months, 12 months, and during long-term follow-up up to 5 years.
|
Change from baseline in quality of life assessed using the EORTC QLQ-C30 questionnaire.
Scores range from 0 to 100 according to EORTC scoring guidelines.
Changes over time will be described within each arm and compared between both randomized arms.
|
Baseline to 6 months, 12 months, and during long-term follow-up up to 5 years.
|
|
Overall Survival
Tidsram: From randomization up to 5 years.
|
Time from randomization to death from any cause.
Participants alive at the end of follow-up will be censored at the date of last contact.
|
From randomization up to 5 years.
|
|
Cancer-Specific Survival
Tidsram: From randomization up to 5 years.
|
Time from randomization to death from endometrial cancer.
Participants alive or deceased from causes unrelated to endometrial cancer will be censored according to the statistical analysis plan.
|
From randomization up to 5 years.
|
|
Recurrence-Free Survival
Tidsram: From randomization up to 5 years.
|
Time from randomization to first documented recurrence of endometrial cancer.
Recurrence may be defined by histological, radiological, or clinical evidence according to standard follow-up criteria.
Participants without recurrence will be censored at the date of last available follow-up.
|
From randomization up to 5 years.
|
Samarbetspartners och utredare
Samarbetspartners
Utredare
- Huvudutredare: Jorge Garcia Fernandez, Hospital Universitari de Bellvitge
- Huvudutredare: Lola Marti, Hospital Universitari de Bellvitge
Publikationer och användbara länkar
Allmänna publikationer
- Minnella EM, Awasthi R, Loiselle SE, Agnihotram RV, Ferri LE, Carli F. Effect of Exercise and Nutrition Prehabilitation on Functional Capacity in Esophagogastric Cancer Surgery: A Randomized Clinical Trial. JAMA Surg. 2018 Dec 1;153(12):1081-1089. doi: 10.1001/jamasurg.2018.1645.
- Concin N, Matias-Guiu X, Vergote I, Cibula D, Mirza MR, Marnitz S, Ledermann J, Bosse T, Chargari C, Fagotti A, Fotopoulou C, Gonzalez Martin A, Lax S, Lorusso D, Marth C, Morice P, Nout RA, O'Donnell D, Querleu D, Raspollini MR, Sehouli J, Sturdza A, Taylor A, Westermann A, Wimberger P, Colombo N, Planchamp F, Creutzberg CL. ESGO/ESTRO/ESP guidelines for the management of patients with endometrial carcinoma. Int J Gynecol Cancer. 2021 Jan;31(1):12-39. doi: 10.1136/ijgc-2020-002230. Epub 2020 Dec 18.
- Davies M, Faerch L, Jeppesen OK, Pakseresht A, Pedersen SD, Perreault L, Rosenstock J, Shimomura I, Viljoen A, Wadden TA, Lingvay I; STEP 2 Study Group. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet. 2021 Mar 13;397(10278):971-984. doi: 10.1016/S0140-6736(21)00213-0. Epub 2021 Mar 2.
- Rubino D, Abrahamsson N, Davies M, Hesse D, Greenway FL, Jensen C, Lingvay I, Mosenzon O, Rosenstock J, Rubio MA, Rudofsky G, Tadayon S, Wadden TA, Dicker D; STEP 4 Investigators. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA. 2021 Apr 13;325(14):1414-1425. doi: 10.1001/jama.2021.3224.
- Akesson A, Wolmesjo N, Adok C, Milsom I, Dahm-Kahler P. Lymphadenectomy, obesity and open surgery are associated with surgical complications in endometrial cancer. Eur J Surg Oncol. 2021 Nov;47(11):2907-2914. doi: 10.1016/j.ejso.2021.06.034. Epub 2021 Jul 1.
- Iavazzo C, Gkegkes ID. Conservative management of patients with endometrial intraepithelial neoplasia (EIN): Factors that could affect response and pregnancy rates. Turk J Med Sci. 2022 Jun;52(3):870. doi: 10.55730/1300-0144.5384. Epub 2022 Jun 16. No abstract available.
- Cui J, Zhao YC, She LZ, Wang TJ. Comparative effects of progestin-based combination therapy for endometrial cancer or atypical endometrial hyperplasia: a systematic review and network meta-analysis. Front Oncol. 2024 May 3;14:1391546. doi: 10.3389/fonc.2024.1391546. eCollection 2024.
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- Fan Z, Li H, Hu R, Liu Y, Liu X, Gu L. Fertility-Preserving Treatment in Young Women With Grade 1 Presumed Stage IA Endometrial Adenocarcinoma: A Meta-Analysis. Int J Gynecol Cancer. 2018 Feb;28(2):385-393. doi: 10.1097/IGC.0000000000001164.
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Termer relaterade till denna studie
Nyckelord
- cancer
- fetma
- endometriecancer
- Semaglutid
- prehabilitering
- hormonbehandling
- blivande
- minimalt invasiv kirurgi
- robotkirurgi
- GLP-1-receptoragonist
- tidigt skede
- endometriehyperplasi
- viktminskning intervention
- endometriekarcinom
- verkliga bevis
- levonorgestrelspiral
- wegovy
- metabolisk optimering
- ClinicalTrial
Ytterligare relevanta MeSH-villkor
- Urogenitala sjukdomar
- Genitala sjukdomar
- Näringsstörningar
- Urogenitala neoplasmer
- Neoplasmer efter plats
- Kvinnliga urogenitala sjukdomar
- Kvinnliga urogenitala sjukdomar och graviditetskomplikationer
- Övernäring
- Kroppsvikt
- Livmodersjukdomar
- Genitala sjukdomar, kvinnor
- Genitala neoplasmer, hona
- Uterina neoplasmer
- Patologiska tillstånd, tecken och symtom
- Närings- och metabola sjukdomar
- Tecken och symtom
- Neoplasmer
- Övervikt
- Fetma
- Endometriella neoplasmer
- Endometriehyperplasi
- Läkemedels fysiologiska effekter
- Hormoner
- Hormoner, hormonsubstitut och hormonantagonister
- Sjukvårdskvalitet, tillgång och utvärdering
- Motorisk aktivitet
- Rörelse
- Muskuloskeletala fysiologiska fenomen
- Muskuloskeletala och neurala fysiologiska fenomen
- Undersökningstekniker
- Epidemiologiska metoder
- Terapeutik
- Diagnostiska tekniker och procedurer
- Diagnos
- Kirurgiska ingrepp, operativ
- Narkotikabehandling
- Minimalt invasiva kirurgiska ingrepp
- Farmakologiska åtgärder
- Kemiska åtgärder och användningar
- Datainsamling
- Hälsovårdsutvärderingsmekanismer
- Hälsovårdskvalitet
- Folkhälsa
- Miljö och folkhälsa
- Fysioterapimetoder
- Polycykliska föreningar
- Graviditet
- Graviditet
- Steroider
- Fusion-ringföreningar
- Patientvård
- Träningsterapi
- Rehabilitering
- Eftervård
- Kontinuitet i patientvård
- Diagnostiska tekniker, kirurgiska
- Endoskopi
- Kemitekniker, analytiska
- Spektrumanalys
- Epidemiologiska mätningar
- Graviditet
- Gravid
- Fysisk konditionering, mänsklig
- Urogenital kirurgiska ingrepp
- Utöva
- Gynekologiska kirurgiska ingrepp
- Förlossningskirurgiska ingrepp
- Medroxiprogesteron
- Hydroxiprogesteroner
- Progesteron
- Megestrol
- Diagnostiska tekniker, obstetriska och gynekologiska
- Hormonersättningsterapi
- Megestrolacetat
- Medroxiprogesteronacetat
- Progestiner
- Magnetresonansspektroskopi
- semaglutid
- Motståndsträning
- Näringsbedömning
- Hysterektomi
- Hysteroskopi
- Östrogenersättningsterapi
Andra studie-ID-nummer
- SHAPE-ENDO
Plan för individuella deltagardata (IPD)
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