Esophagectomy in Middle and Lower Thoracic Esophageal Cancer Patients Through Left Versus Right Transthoracic Approach
2015年5月17日 更新者：Jie He、Cancer Institute and Hospital, Chinese Academy of Medical Sciences
Randomized Control Study on Surgical Treatment for Middle and Lower Thoracic Esophageal Cancer Patients Without Upper Mediastinal Lymph Node Metastasis Through Left Versus Right Transthoracic Approach
Esophageal carcinoma is an aggressive malignant disease with poor prognosis.
Surgical resection remains the most effective method for this malignancy.
Although different approaches have been studied for the surgical resection of thoracic esophageal cancer, little evidence has been achieved due to lack of large scale multicenter randomized trials with regard to this issue: whether left transthoracic approach or right transthoracic approach is the optimal surgical approach for treating middle and lower thoracic esophageal cancer without upper mediastinal lymph node metastasis.
The purpose of this study is to compare the postoperative local recurrence rate and long-term outcome of esophagectomy through left and right transthoracic approach in the middle and lower thoracic esophageal cancer patients without preoperative upper mediastinal lymph node metastasis.
研究概览
详细说明
Esophageal carcinoma is an aggressive malignant disease with poor prognosis.
Surgical resection remains the most effective method for this malignancy.
As to the middle and lower thoracic esophageal cancer patients without upper mediastinal lymph node metastasis, the rational transthoracic approach either through right or left chest has not been clarified to date due to lack of large scale multicenter randomized trials.
Although some randomized trials had been finished in single-center, there is no enough evidences that all lower and middle thoracic esophageal cancer patients should be surgically treated throuhg right chest approch.
It is widely recognized that left thoracotomy approach(Sweet procedure) is not appropriate in the patients with upper mediastinal lymph node metastasis, because patients can benefit from the right thoracotomy approach, through which upper mediastinal lymph node can be dissected completely and may get a better long-term survival.Therefore,in this study, the enrolled patients are the middle and lower thoracic esophageal cancer patients without preoperative upper mediastinal lymph node metastasis by CT and/or ultrasound, and 10 hospitals will participate this study.
Through comparison in postoperative complications and long term outcomes as well as locoregional recurrence between the left and right apppoach, hopefully we can answer the question whether the right or left transthoracic procedure is the optimal approach for treating middle and lower thoracic esophageal cancer patients without preoperative upper mediastinal lymph node metastasis.
研究类型
介入性
注册 (预期的)
800
阶段
- 第三阶段
联系人和位置
本节提供了进行研究的人员的详细联系信息，以及有关进行该研究的地点的信息。
学习地点
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Beijing
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Beijing、Beijing、中国、100021
- 招聘中
- Cancer Hospital, Chinese Academy of Medical Sciences
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参与标准
研究人员寻找符合特定描述的人，称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
18年 至 75年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- Patients with histologically proved squamous cell esophageal cancer without any previous anti-tumor therapy;
- The preoperative clinical TNM stage: cT1b-3N0-1M0;
- Adequate function of heart, lung, liver, brain and kidney, which can tolerate esophagectomy either through left or right thoracotomy;
- Without any preoperative distant metastases confirmed by preoperative examination such as chest and abdominal CT, brain MRI and bone scan or PET-CT;
- No evidence showing suspicious upper mediastinal lymph node metastasis (short diameter of LN <0.8cm or shortest diameter / longest diameter <0.65) by the thoracic and abdominal CT and endoscopic ultrasonography(EUS).
- Willing to participate the clinical trial and sign informed consent before being enrolled into clinical trail.
Exclusion Criteria:
- Non-squamous cell esophageal carcinoma or has any previous anti-cancer therapy before surgery;
- The preoperative clinical TNM stage reaches: N2-3 or M1;
- Inadequate cardiopulmonary, liver, brain and kidney function for tolerating the esophagectomy ;
- Previous history of malignancy;
- Unwilling to participate the clinical trial and refuse to sign informed consent
学习计划
本节提供研究计划的详细信息，包括研究的设计方式和研究的衡量标准。
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
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有源比较器：Left thoracotomy
Esophagectomy through left side transthoracic approach, with esophagogastric anastomosis above aortic arch and two-field lymphadenectomy (thoracic and abdominal lymph node)
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Transthoracic approach is the surgical procedure including the open and minimally invasive thoracotomy.
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有源比较器：Right thoracotomy
Esophagectomy through right side transthoracic approach, with esophagogastric anastomosis above azygos vain arch or on the top of chest cavity and two-field lymphadenectomy (thoracic and abdominal lymph node)
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Transthoracic approach is the surgical procedure including the open and minimally invasive thoracotomy.
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研究衡量的是什么？
主要结果指标
结果测量 |
大体时间 |
|---|---|
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长期生存
大体时间：5年
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5年
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次要结果测量
结果测量 |
大体时间 |
|---|---|
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无病生存
大体时间：5年
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5年
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Degree of lymph node dissection
大体时间：3 years
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3 years
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术后并发症
大体时间：3年
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3年
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查，以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2015年1月1日
初级完成 (预期的)
2017年12月1日
研究完成 (预期的)
2019年12月1日
研究注册日期
首次提交
2015年5月8日
首先提交符合 QC 标准的
2015年5月17日
首次发布 (估计)
2015年5月20日
研究记录更新
最后更新发布 (估计)
2015年5月20日
上次提交的符合 QC 标准的更新
2015年5月17日
最后验证
2015年5月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索，没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求，请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改，我们的网站上也会自动更新.
Left thoracotomy的临床试验
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Ottawa Hospital Research InstituteUniversity Hospital, Geneva; Leiden University Medical Center未知