RecruitingNot ApplicableNCT03465982

Timing to Minimally Invasive Surgery After Neoadjuvant Chemoradiotherapy for Rectal Cancer

Timing to Minimally Invasive Surgery After Neoadjuvant Chemoradiotherapy for Rectal Cancer: a Multicenter Randomised Controlled Trial


Sponsor

Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo di Alessandria

Enrollment

340 participants

Start Date

Jun 5, 2018

Study Type

INTERVENTIONAL

Conditions

Summary

The trial is a multicenter, prospective, randomized controlled, unblinded, parallel-group trial comparing standard and delayed surgery after neoadjuvant chemoradiotherapy for the curative treatment of rectal cancer. Three-hundred and thirty-two patients will be randomized on an equal basis to either robotic-assisted/standard laparoscopic rectal cancer surgery after 8 weeks or robotic-assisted/standard laparoscopic rectal cancer surgery after 12 weeks. The recruiting interval will be of 5 years and the follow-up period will end 5 years after the last patient is randomized.


Eligibility

Min Age: 18 Years

Inclusion Criteria9

  • Age \>18 years
  • cT3/4N0/+M0 confirmed on CT-scan, MRI (stratification for T3a-b-c-d) 3
  • Tumor starting from the distal or medium rectum (even those crossing the peritoneal reflection at distal margin, within 15 cm from the anal margin)
  • Histologically-proven adenocarcinoma of the rectum
  • Eligible for a resective surgery with TME (low anterior resection, intersphincteric resection, abdominoperineal resection)
  • Eligible for resection by minimally-invasive surgery (standard or robotic-assisted laparoscopic procedure, all robotic systems will be accepted)
  • Eligible for chemoradiation treatment
  • Able to give written informed consent
  • Capable of completing required questionnaires at time of consent (provided questionnaires are available in a language spoke fluently by the participant)

Exclusion Criteria12

  • Metastatic disease
  • Squamous carcinoma of the anal canal
  • Synchronous colorectal tumors requiring multi-segment surgical resection (n.b. a benign lesion within the resection field in addition to the main cancer would not exclude a patient)
  • History of psychiatric or addictive disorder or other medical condition that, in the opinion of the investigator, would preclude the patient from meeting the trial requirements
  • Pregnancy
  • Unable to complete neoadjuvant treatment
  • Unable to give free informed consent
  • Previous radiation treatment on the pelvis
  • Inflammatory bowel disease
  • Hereditary colorectal disease
  • Previous tumors other than non-melanoma skin cancer, papillary or follicular thyroid cancer
  • Participation in another rectal cancer clinical trial relating to the topic of this trial

Interventions

PROCEDURESurgery after 8 weeks from chemoradiation treatment

Minimally invasive surgery after 8 weeks from chemoradiation treatment

PROCEDURESurgery after 12 weeks from chemoradiation treatment

Minimally invasive surgery after 12 weeks from chemoradiation treatment


Locations(14)

SS. Antonio e Biagio e Cesare Arrigo Hospital

Alessandria, AL, Italy

Ospedale Gian Battista Morgagni - Luigi Pierantoni

Forlì, Forlì-Cesena, Italy

Ospedale Civile Pietro Cosma

Camposampiero, Padua, Italy

Ospedale Sacro Cuore

Negrar, Verona, Italy

Ente Ecclesiastico ospedale generale Regionale Miulli

Acquaviva delle Fonti, Italy

Ospedale degli Infermi

Biella, Italy

Istituto del Radio Olindo Alberti, Spedali Civili di Brescia

Brescia, Italy

ASST Ospedale di Cremona

Cremona, Italy

Azienda Ospedaliera Universitaria Careggi

Florence, Italy

Ospedale Maggiore Policlinico Fondazione Ca' Granda

Milan, Italy

Ospedale San Raffaele IRCCS

Milan, Italy

Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale

Napoli, Italy

Ospedale San Francesco

Nuoro, Italy

Azienda Ospedaliera San Giovanni - Addolorata

Roma, Italy

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NCT03465982


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