RecruitingNot ApplicableNCT04735198

Prophylactic Cholecystectomy in Midgut NETs Patients Who Require Primary Tumor Surgery.

Effectiveness of Prophylactic Cholecystectomy in Patients With Midgut Neuroendocrine Tumor (Jejunum, Ileum or Proximal Colon) Who Require Primary Tumor Surgery. Randomized, Proof of Concept Clinical Trial.


Sponsor

Hospital Universitari de Bellvitge

Enrollment

100 participants

Start Date

Jan 20, 2021

Study Type

INTERVENTIONAL

Conditions

Summary

The investigators want to study the effectiveness of prophylactic cholecystectomy in patients with midgut neuroendocrine tumor (jejunum, ileum or proximal colon) who require primary tumor surgery. When patients are diagnosed and are tributary to surgical treatment, the tumor might compromise vascularization, and patients need an extensive bowel resection. The patients might also receive medical treatment with somatostatin analogs. The combination of extensive bowel resection and medical treatment might increase gallbladder stones, but patients might not develop biliary stone disease, as in the general population, where 20% of the population have gallbladder stones but only a 10 to 15 % of the population will develop symptoms. The idea comes from the lack of literature about the incidence of biliary Stone disease in patients with midgut NET tumors. It's a multicentric, open-label and randomized clinical trial to evaluate the incidence of biliary stone disease in patients with midgut NET who require primary tumor surgery combined or not to cholecystectomy. Our hypothesis suggests that patients with midgut neuroendocrine tumor who require primary tumor resection without the combination of prophylactic cholecystectomy do not have an increased incidence of biliary stone disease two years after the surgery, regardless of treatment with SSA.


Eligibility

Min Age: 18 Years

Inclusion Criteria8

  • Patients must grant the informed consent written, signed and dated.
  • Male or female older than 18 years old.
  • Radiological or histological diagnose of midgut NET that can be treated with surgery.
  • In case of female with childbearing age (time between menarche and menopause), a pregnancy test with negative result.
  • Neuroendocrine tumors located in any of the aforementioned locations.
  • Presence or not of distant metastasis.
  • Presencié or not of gallstones.
  • Capacity of follow up.

Exclusion Criteria10

  • Neuroendocrine tumors which are not located in jejunum or ileum (bronchial, gastric, pancreatic, descending colon, sigma or rectum.).
  • Patients that have gone through a previous bowel resection.
  • Patients with previous cholecystectomy.
  • Pacients with biliary stone disease.
  • Patients who are candidate to liver resection or liver transplant.
  • Patients with a gallbladder polyp bigger than 6 mm.
  • Pacients with one gallbladder sessile polyp, presence of more than one polyp or patients older than 50 years old with a polyp.
  • Refusal to participate.
  • Patients with previous history of malignant neoplasms in the last 5 years, except skin basal cell carcinoma, "in situ" cervical carcinoma or in situ carcinoma found in a polyp removed with a colonoscopy.
  • Medical criteria that doesn't consider the patient a candidate to participate in the study.

Interventions

PROCEDUREPrimary tumor surgery

Large bowel resection.

PROCEDUREPrimary tumor surgery (bowel resection) combined with prophylactic cholecystectomy

Large bowel resection combined and cholecystectomy.


Locations(6)

Hospital Universitari Trias i Pujol

Badalona, Barcelona, Spain

IDIBELL, Hospital Universitari de Bellvitge.

Barcelona, Barcelona, Spain

Hospital del Mar

Barcelona, Barcelona, Spain

Hospital Universitari Vall d'Hebron

Barcelona, Barcelona, Spain

Instituto Catalán de Oncología

L'Hospitalet de Llobregat, Barcelona, Spain

Hospital Universitario Gregorio Marañón

Madrid, Madrid, Spain

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NCT04735198