Comparison of Laparoscopic and Open Total Gastrectomy for Locally Advanced Gastric Cancer
Ориентир для пациента и семьи
Простыми словами
Автоматическая сводка по структурированным данным реестра. Она помогает сориентироваться, но не заменяет официальный протокол или оценку врача.
- Что изучают
- В протоколе указаны: Laparoscopic gastrectomy.
- Кому может быть актуально
- Состояния в реестре: Gastric Cancer. Базовые параметры: 18 лет — 80 лет · Все.
- Что важно проверить
- Возраст, диагноз и пол — только базовые ориентиры. Предыдущее лечение, анализы и другие обязательные условия указаны ниже в критериях участия.
- Где проводится
- Вьетнам
- Следующий шаг
- Сохраните исследование, покажите его лечащему врачу и уточните актуальный статус у исследовательского центра. Расходы, документы и поездка →
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Официальное название
Comparison of Laparoscopic Versus Open Total Gastrectomy for Locally Advanced Gastric Cancer: a Prospective Randomized Control Trial
Обзор
Evidence of implementation of laparoscopic total gastrectomy (LTG) for locally advanced gastric cancer (GC) remains inadequate. This study aimed to compare short- and mid-term outcomes of LTG versus open total gastrectomy (OTG) for cT2-4a GC.
Подробное описание
Gastric cancer (GC) is a significant public health issue worldwide. Surgical resection and lymphadenectomy is the first option for curative treatment of this disease. For tumors located in the middle and/or upper third of the stomach, open total gastrectomy (OTG) has long been the standard surgery.
While the advantage of laparoscopic distal gastrectomy over open distal gastrectomy for not only early gastric cancer (EGC) but also locally advanced gastric cancer (AGC) had been proven, the use of laparoscopic total gastrectomy (LTG) for GC, particularly for AGC, has not been widely accepted due to technical challenges with lymphadenectomy at the distal pancreas and the splenic hilum as well as the complexity of the esophago-jejunal reconstruction. Recently, there has been advancement in laparoscopic techniques and improved surgical experience, a standard procedure of LTG has been established, leading to increase utilization of LTG, especially for EGC. Two large RCTs, KLASS-03 in Korea and CLASS-02 in China, provided good evidence for the advantages of LTG for EGC. However, for AGC, some prior studies have demonstrated the safety of LTG compared to OTG but lacked significant data for survival. Until now, there have been no completed RCTs to determine the short- and long-term outcomes of LTG for AGC.
In the research center, LTG has been accepted as a standard procedure for EGC since 2008 and for AGC since 2013. In Vietnam and other low-to-middle-income countries, most GC was diagnosed in an advanced stage. It is needed to have evidence of the feasibility, safety, and oncological results of LTG for locally advanced GC. Investigators performed this study to compare the technical feasibility, short- and long-term outcomes of LTG versus OTG for stage T2-4a GC.
Вмешательства
- Процедура Laparoscopic gastrectomy
Gastrectomy with laparoscopic approach
Первичные конечные точки
- 3 year overall survival by Kaplan Mayer [Срок оценки: 3 year after surgery]
- 3 year relapse-free survival by Kaplan Mayer [Срок оценки: 3 year after surgery]
Вторичные конечные точки (5)
- operative morbidity [Срок оценки: 30 days after surgery]
- operative mortality [Срок оценки: 30 days after surgery]
- operative time [Срок оценки: intraoperative]
- Resected lymph nodes [Срок оценки: intraoperative]
- hospital stay [Срок оценки: 30 days after surgery]
Критерии участия
Критерии включения
- Pathologic finding by gastric endoscopy: confirmed gastric adenocarcinoma
- Age: 18 - 80 year old
- Tumor required total gastrectomy for radical treatment
- Preoperative cancer stage (CT scan stage): cT2-4aNanyM0
- ASA score: ≤ 3
- Informed consent patients (explanation about our clinical trials is provided to the patients or patrons, if patient is not available)
Критерии исключения
- Concurrent cancer or patient who was treated due to other cancer before the patient was diagnosed gastric cancer
- Bulky lymph node andd/or Para-aortic lymph node metastasis
- Combined esophagectomy due to invading to the esophagus
- Pregnant patient
Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.
Здоровые добровольцы: Нет
Дизайн исследования
- Распределение
- Рандомизированное
- Модель
- Параллельные группы
- Маскирование
- Простое слепое
- Основная цель
- Лечение
Центры проведения
Вьетнам · 3 центра
- Dong Nai General Hospital — Bien Hoa
- 108 Military Central Hospital — Hà Nội
- University Medical Center Ho Chi Minh City — Ho Chi Minh City
Идентификаторы
NCT: NCT06202105 · LOTA