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Gastric CancerNCT02325453

Robotic, Laparoscopic and Open Surgery for Gastric Cancer Compared on Surgical, Clinical and Oncological Outcomes

An observational study of Gastric Cancer, run by International Study Group on Minimally Invasive Surgery for Gastric Cancer at 1 site in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Gastric cancer represents a great challenge for health care providers and requires a multidisciplinary context in which surgery plays a main role. Minimally invasive surgery has been progressively developed, first with the advent of laparoscopy and more recently with the spread of robotic systems, but a number of… Read more about this study

Who is it for?
Any age
Conditions the study is for
Gastric Cancer
What is being tested?
Robotic Surgery, Laparoscopic Surgery and Open Surgery
Type of treatment
Surgery or procedure
How many people
7,000 participants
Where
1 siteItaly
Study dates
May 2015to Jan 2020
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages Any age
  • All sexes
  • No healthy volunteers
  • Child, Adult, Older adult

Study population: Subjects undergoing surgery for gastric cancer with robotic, laparoscopic or open approaches and subsequent follow-up.

Who may be able to join

  • Histologically proven gastric cancer
  • Preoperative staging work-up performed by upper endoscopy / endoscopic ultrasound, and CT scan
  • Early Gastric Cancer
  • Advanced Gastric Cancer
  • Patients treated with curative intent in accordance to international guidelines

Who cannot join

  • Locally advanced tumor infiltrating neighboring organs
  • Distant metastases: peritoneal carcinomatosis, liver metastases, distant lymph node metastases, Krukenberg tumors, involvement of other organs
  • Patients with high operative risk as defined by the American Society of Anesthesiologists (ASA) score ≥4.
  • History of gastric surgery
  • Remnant gastric cancer
  • Synchronous other major abdominal surgery
  • Synchronous malignancy in other organs
  • Palliative surgery cases

Trial locations and contacts

1 site in 1 country.

Jacopo Desiderio, MD contact

+393497531121

djdesi85@hotmail.it

Amilcare Parisi, MD contact

amilcareparisi@virgilio.it

Italy1 site, 1 recruiting
  • Department of Digestive Surgery, St. Mary's Hospital, University of Perugia

    Terni, 05100

    Amilcare Parisi, amilcareparisi@virgilio.it

    Jacopo Desiderio, djdesi85@hotmail.it

    Recruiting

Other trials in Italy

About this study

Official title: A Multi-Institutional Chart Review to Compare the Outcomes of Robotic, Laparoscopic and Open Surgery for Gastric Cancer.

Gastric cancer represents a great challenge for health care providers and requires a multidisciplinary context in which surgery plays a main role.

Minimally invasive surgery has been progressively developed, first with the advent of laparoscopy and more recently with the spread of robotic systems, but a number of issues are currently being debated, including the limitations in performing effective extended lymph node dissections and, in this context, the real advantages of using the robotic systems, the possible role for the Advanced Gastric Cancer, the reproducibility of completely intracorporeal techniques and the oncological results achievable during follow-up.

A multicenter study with a large number of patients is now needed to further investigate the safety and efficacy as well as long-term outcomes of robotic surgery, traditional laparoscopy and the open approach.

Read the detailed description

Overall purpose:

The Overall purpose is to develop a multi-institutional database comprising information regarding surgical, clinical and oncological features of patients undergoing surgery for gastric cancer with robotic, laparoscopic or open approaches and subsequent follow-up at participating centers.

General study design:

The registry will be established by retrospectively identifying subjects with gastric cancer treated at the participating centers.

Information gathered will be obtained from existing data and records, diagnostic tests and surgical interventions.

Information will be collected and recorded by all institutes through a specific online shared system.

Main objectives:

  • To determine the surgical, clinical, and oncological outcomes in both the short and long term
  • To compare results according to the type of intervention, device used and manner of execution of different surgical phases
  • To relate results of different surgeries with baseline characteristics of patients and stage of disease

Clinical relevance:

Studies that reported results of minimally invasive surgery for gastric cancer and recent meta-analysis emphasize the need for large trials.

A further consideration in this field regards the need of numerous patients to reach a statistical significance on surgical, clinical and oncological outcomes, in order to fully assess the effectiveness and the differences between the different surgical approaches.

At present, a multicenter registry may represent the best research tool to assess the role of minimally invasive approaches by comparing the methods with traditional open surgery.

Therefore, for this project, a large registry will be created by collecting data from the different participating centers to create a working basis for analyzing outcomes of interest and obtaining directions for further investigation.

The data collected will clarify the role of laparoscopic and robotic surgery versus the open approach in terms of:

  • safety and feasibility based on the intraoperative outcomes
  • respect of oncological principles in relation to the stage and location of the tumor
  • recovery of gastrointestinal function considering the outcomes measured during the postoperative hospital stay
  • incidence, types and severity of postoperative complications
  • overall survival and disease-free survival

Duration of study:

The beginning of the trial is scheduled for January 2015. It is expected to end the chart review within one year.

Type of data collection:

In the present study, the following information will be collected:

  • Patient Demographics
  • Surgical Procedure details
  • Tumor characteristics
  • Operative findings
  • Post-operative clinical findings
  • Post-operative complications
  • Follow-up details

Statistical analysis:

The dichotomous variables will be expressed as numbers and percentages, while continuous variables will be expressed as mean and standard deviation (SD) or median and interquartile range (minimum and maximum values).

Continuous variables, will be compared using one-way ANOVA with post hoc multiple comparison by Tukey's procedure. Pearson's χ2 test or Fisher's exact test, as appropriate, will be used for analysis of categorical data.

For each of these tests a value of alpha (α) < 0.05 will be considered statistically significant.

Potential risks and safety management:

Participation in the research registry involves the potential risks of a breach of confidentiality of the medical record information and associated privacy of the participants.

Such risks will be minimized by the use and the establishment of appropriate information technology services.

Conditions
Gastric Cancer
Being tested
Robotic Surgery, Laparoscopic Surgery, Open Surgery
Keywords
Robotic Surgery, Laparoscopic Surgery, Minimally Invasive Surgery, Robotic Gastrectomy, Laparoscopic Gastrectomy, Open Gastrectomy, Gastric Surgery
Medical subject headings
Stomach Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Robotic SurgeryProcedure or surgery

    Surgical procedure performed with a robotic system.

  • Laparoscopic SurgeryProcedure or surgery

    Surgical procedure performed with laparoscopic techniques.

  • Open SurgeryProcedure or surgery

    Traditional approach for gastric cancer.

Study groups in NCT02325453
Study groupRoleWhat they receive
Robotic SurgeryPatients underwent gastric surgery through the use of a robotic system.
Receives: Procedure: Robotic Surgery
Laparoscopic SurgeryPatients underwent gastric surgery with laparoscopic procedures.
Receives: Procedure: Laparoscopic Surgery
Open SurgeryPatients underwent gastric surgery with open approach.
Receives: Procedure: Open Surgery

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Compare robotic and laparoscopic surgery with the open approach in terms of safety and feasibility. (Intraoperative complications.)

    Intraoperative complications.

    Measured: Intraoperative.

  2. Verify the respect of oncological principles through minimally invasive approaches in relation to the stage and location of the tumor by comparing results with open surgery. (Number of lymph nodes retrieved.)

    Number of lymph nodes retrieved.

    Measured: Intraoperative.

  3. Compare the three treatment arms in terms of recovery of gastrointestinal functions and physical status allowing the discharge of the patient. (Days of hospitalization after surgery until discharge.)

    Days of hospitalization after surgery until discharge.

    Measured: Assessment during an average period of 10 days after surgery.

  4. Compare the incidence, types and severity of early postoperative complications after gastrectomy by the three approaches. (Score based on the Clavien-Dindo classification system.)

    Score based on the Clavien-Dindo classification system.

    Measured: Assessment during an average period of 10 days after surgery.

  5. Verify whether minimally invasive approaches ensure the same effectiveness than open surgery. (Overall survival.)

    Overall survival.

    Measured: Assessment at 1, 3, 5 years from surgery.

  6. Compare the three treatment arms in terms of tumor recurrence after treatment. (Disease-free survival)

    Disease-free survival.

    Measured: Assessment at 1, 3, 5 years from surgery.

Secondary outcomes (3)
  1. Verify the safety of intracorporeal anastomosis in comparison with extracorporeal anastomosis. (Anastomotic leakage)

    Anastomotic leakage.

    Measured: Assessment during an average period of 10 days after surgery.

  2. Compare the intracorporeal anastomosis with the extracorporeal anastomosis to evaluate post-operative recovery. (Days of hospitalization after surgery until discharge.)

    Days of hospitalization after surgery until discharge.

    Measured: Assessment during an average period of 10 days after surgery.

  3. Verify whether robotic gastrectomy, compared with laparoscopic or open techniques, is capable of improving postoperative surgical stress. (Granulocyte-to-lymphocyte ratio.)

    Granulocyte-to-lymphocyte ratio.

    Measured: Assessment during an average period of 10 days after surgery.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Dec 2014 (estimated)
  2. Study startMay 2015
  3. Primary completionJan 2020 (estimated)
  4. Study completionJan 2020 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Retrospective
Enrolment
7,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02325453
Sponsor's protocol ID
001
Status last verified
Apr 2019
First submitted
16 Dec 2014
Last updated
22 Apr 2019
Results posted
No
Data monitoring committee
No

Publications

  • Vinuela EF, Gonen M, Brennan MF, Coit DG, Strong VE. Laparoscopic versus open distal gastrectomy for gastric cancer: a meta-analysis of randomized controlled trials and high-quality nonrandomized studies. Ann Surg. 2012 Mar;255(3):446-56. doi: 10.1097/SLA.0b013e31824682f4.

    PubMed 22330034
  • Alimoglu O, Atak I, Eren T. Robot-assisted laparoscopic (RAL) surgery for gastric cancer. Int J Med Robot. 2014 Sep;10(3):257-62. doi: 10.1002/rcs.1566. Epub 2013 Dec 23.

    PubMed 24375986
  • Shen WS, Xi HQ, Chen L, Wei B. A meta-analysis of robotic versus laparoscopic gastrectomy for gastric cancer. Surg Endosc. 2014 Oct;28(10):2795-802. doi: 10.1007/s00464-014-3547-1. Epub 2014 May 2.

    PubMed 24789136
  • Marano A, Choi YY, Hyung WJ, Kim YM, Kim J, Noh SH. Robotic versus Laparoscopic versus Open Gastrectomy: A Meta-Analysis. J Gastric Cancer. 2013 Sep;13(3):136-48. doi: 10.5230/jgc.2013.13.3.136. Epub 2013 Sep 30.

    PubMed 24156033
  • Liao G, Chen J, Ren C, Li R, Du S, Xie G, Deng H, Yang K, Yuan Y. Robotic versus open gastrectomy for gastric cancer: a meta-analysis. PLoS One. 2013 Dec 3;8(12):e81946. doi: 10.1371/journal.pone.0081946. eCollection 2013.

    PubMed 24312610
  • Hyun MH, Lee CH, Kim HJ, Tong Y, Park SS. Systematic review and meta-analysis of robotic surgery compared with conventional laparoscopic and open resections for gastric carcinoma. Br J Surg. 2013 Nov;100(12):1566-78. doi: 10.1002/bjs.9242.

    PubMed 24264778
  • Desiderio J, Jiang ZW, Nguyen NT, Zhang S, Reim D, Alimoglu O, Azagra JS, Yu PW, Coburn NG, Qi F, Jackson PG, Zang L, Brower ST, Kurokawa Y, Facy O, Tsujimoto H, Coratti A, Annecchiarico M, Bazzocchi F, Avanzolini A, Gagniere J, Pezet D, Cianchi F, Badii B, Novotny A, Eren T, Leblebici M, Goergen M, Zhang B, Zhao YL, Liu T, Al-Refaie W, Ma J, Takiguchi S, Lequeu JB, Trastulli S, Parisi A. Robotic, laparoscopic and open surgery for gastric cancer compared on surgical, clinical and oncological outcomes: a multi-institutional chart review. A study protocol of the International study group on Minimally Invasive surgery for GASTRIc Cancer-IMIGASTRIC. BMJ Open. 2015 Oct 19;5(10):e008198. doi: 10.1136/bmjopen-2015-008198.

    PubMed 26482769

Questions about this trial

What is this clinical trial studying?

An observational study of Gastric Cancer, run by International Study Group on Minimally Invasive Surgery for Gastric Cancer at 1 site in Italy.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 22 Apr 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Jacopo Desiderio, MD (+393497531121, djdesi85@hotmail.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Compare robotic and laparoscopic surgery with the open approach in terms of safety and feasibility. (Intraoperative complications.) (time frame: Intraoperative.). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02325453, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Apr 2019.

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