AzTrials
AzTrials

Cervical CancerFUSIONIVNCT02986568

Efficacy of the Standard Treatment and Fusion Ontogenetic Surgery for Gynecologic Cancers

A study testing Cervical cancer, Uterine cancer and Cervical cancer, pelvic sidewall invasion in people with Cervical Cancer and Uterine Cancer, run by Seoul National University Hospital at 1 site in South Korea.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Trial summary

The purpose of this study is to compare standard treatment and fusion ontogenetic surgery (total mesometrial resection, laterally extended endopelvic resection, peritoneal mesometrial resection) for gynecologic cancer in order to evaluate treatment response, adverse effect and survival. Read more about this study

Who is it for?
Ages 20 years and older, women only
Conditions the study is for
Cervical Cancer, Uterine Cancer
What is being tested?
Cervical cancer, Uterine cancer and Cervical cancer, pelvic sidewall invasion
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
380 participants
Where
1 siteSouth Korea
Study dates
10 May 2016to 31 Dec 2025
Phase
Interventional
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 20 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Female, Age ≥ 20 years
  • Patients with primary, recurrent, or refractory cervical cancer (FIGO stage IB1-IVA), primary, recurrent, or refractory uterine cancer (FIGO stage IA, grade 3, IB-IVA), or gynecologic cancer patients showing pelvic sidewall recurrence.
  • ECOG performance status 0 or 1
  • Extensive surgery might be expected to cure the disease, or expected to relieve severe pelvic pain.
  • Patients who signed an approved informed consent
  • Patients who do not have a treatment option other than surgery.

Who cannot join

  • Female, Age < 20 years
  • ECOG performance status ≥2
  • Bilateral pelvic sidewall invasion
  • Patients who had undergone radical hysterectomy, trachelectomy, or hysterectomy in case of the primary disease.
  • Patients who refused to sign an informed consent

Trial locations and contacts

1 site in 1 country.

Hee Seung Kim, MD contact

82-2-2072-4863

bboddi0311@gmail.com

South Korea1 site, 1 recruiting
  • Seoul National University Hospital

    Seoul

    Soo jin Park, MD, 82-2-2072-0897, soojin.mdpark@gmail.com

    Hee Seung Kim, MD, 82-2-2072-4863, bboddi0311@gmail.com

    Recruiting

Other trials in South Korea

About this study

Official title: Cohort Study for Comparing the Efficacy Between the Standard Treatment and Fusion Ontogenetic Surgery for Gynecologic Cancers (FUSION Trial IV)

The purpose of this study is to compare standard treatment and fusion ontogenetic surgery (total mesometrial resection, laterally extended endopelvic resection, peritoneal mesometrial resection) for gynecologic cancer in order to evaluate treatment response, adverse effect and survival.

Read the detailed description

Fujii method and ontogenetic surgery are the surgical method of radical hysterectomy that can preserve pelvic organ function as much as possible.

Fujii method has advantage of preserving pelvic autonomic nerve with radical resection of tissue under parametrium. And ontogenetic surgery has advantage of reducing need of radiation therapy by radical resection of tissue above parametrium.

This study is prospective study for fusion ontogenetic surgery that has the advantage of both Fujji method and ontogenetic surgery.

Being tested
Cervical cancer, Uterine cancer, Cervical cancer, pelvic sidewall invasion, Non-cervical cancer, pelvic sidewall invasion
Keywords
Ontogenetic surgery, TMMR, PMMR, LEER
Medical subject headings
Uterine Cervical Neoplasms, Uterine Neoplasms

What participants receive

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

  • Cervical cancerProcedure or surgery

    If tumor sized ≥ 5cm, undergo neoadjuvant chemotherapy with Cisplatin before surgery. (40mg/m2 on day 1 of each 7 day cycle for 5 cycles), then perform Fusion TMMR after neoadjuvant chemotherapy with cisplatin as above.

    If tumor size < 5cm, perform Fusion Total mesometrial resection (TMMR)

    After surgery, if resection margin, more than two pelvic lymph node or more than one para-aortic lymph node is positive in pathologic report, undergo adjuvant chemotherapy.

    If not, no adjuvant therapy.

  • Uterine cancerProcedure or surgery

    Perform Fusion Peritoneal mesometrial resection (PMMR).

    After surgery, if resection margin, more than two pelvic lymph node or more than one para-aortic lymph node is positive in pathologic report, undergo adjuvant chemotherapy.

    If not, no adjuvant therapy.

  • Cervical cancer, pelvic sidewall invasionProcedure or surgery

    Perform Fusion Laterally extended endopelvic resection (LEER).

    After surgery, if resection margin, more than two pelvic lymph node or more than one para-aortic lymph node is positive in pathologic report, undergo adjuvant chemotherapy. Patients with primary disease will be treated with adjvuant chemotherapy. In case of recurrent disease, bevacizumab, paclitaxel, and cisplaitn will be administered regardless of the pathologic report (bevacizumab 15mg/kg on day 1, paclitaxel 135mg/m2 on day 1, and cisplatin 50mg/m2 on day 2, of each 21 day cycle).

    If not, no adjuvant therapy.

  • Non-cervical cancer, pelvic sidewall invasionProcedure or surgery

    Perform Fusion Laterally extended endopelvic resection (LEER).

    After surgery, appropriate adjuvant chemotherapy will be administered depending on the tumor type.

Study groups in NCT02986568
Study groupRoleWhat they receive
Cervical cancerExperimental* Primary cervical cancer patients, FIGO stage IB1-IIB * Refractory cervical cancer patients who do not respond to concurrent chemoradiotherapy or radiotherapy * Recurrent cervical cancer after concurrent chemoradiotherapy or radiotherapy
Receives: Procedure: Cervical cancer
Uterine cancerExperimental* Primary uterine cancer patients, FIGO stage IA, grade3, IB-IVA * Refractory uterine cancer who does not respond to concurrent chemoradiotherapy or radiotherapy * Recurrent uterine cancer after concurrent chemoradiotherapy or radiotherapy
Receives: Procedure: Uterine cancer
Cervical cancer, pelvic sidewall invasionExperimentalCervical cancer patients showing pelvic sidewall invasion * Primary cervical cancer * Refractory cervical cancer patients who do not respond to concurrent chemoradiotherapy or radiotherapy * Recurrent cervical cancer after concurrent chemoradiotherapy or radiotherapy
Receives: Procedure: Cervical cancer, pelvic sidewall invasion
Non-cervical cancer, pelvic sidewall invasionExperimental* Gynecologic cancer patients other than cerivcal cancer, showing pelvic sidewall invasion with or without distant metastasis * Patients showing uncontrolled pelvic pain due to the tumor invasion
Receives: Procedure: Non-cervical cancer, pelvic sidewall invasion

What is being measured

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

  1. Progression-free survival

    The time interval from treatment start date to disease recurrence or progression date

    Measured: From date of treatment start until the date of first documented progression or date of death (by any cause, in the absence of disease progression) whichever came first, assessed up to 60 months

  2. Overall survival

    the time interval from treatment start date to death or end of study date

    Measured: From the date of treatment start until death due to any cause, assessed up to 60 months

  3. Treatment-free interval

    The time interval from treatment end date to disease recurrence or progression date

    Measured: From date of treatment end until the date of first documented progression or date of death (by any cause, in the absence of disease progression) whichever came first, assessed up to 60 months

  4. Treatment-related survival

    the time interval from treatment start date to death or end of study date (recurrent or refractory disease)

    Measured: the time interval from treatment start date to death or end of study date assessed up to 60 months

Secondary outcomes (6)
  1. Tumor response

    Tumor response after surgery, and the evaluation is based on revised RECIST version 1.1

    Measured: 3 weeks after completion of ontogenetic surgery up to 6 weeks

  2. Postoperative complications 1

    Incidence of early complications, and severity of complications based on Memorial Sloan Kettering Cancer Center Surgical Secondary Events Grading System

    Measured: after the ontogenetic surgery, up to 30 days

  3. Postoperative complications 2

    Incidence of late complications, and severity of complications based on Memorial Sloan Kettering Cancer Center Surgical Secondary Events Grading System

    Measured: 31 days after the ontogenetic surgery through study completion, an average of 1 year

  4. Neurologic disturbance of low extremity

    Incidence of motor and sensory disturbances of low extremities, and the grading is based on Common Terminology Criteria for Adverse Events (CTCAE) v5.0

    Measured: after the ontogenetic surgery, up to 30 days

  5. Pain evaluation

    Pelvic pain evaluated by numeric rating scale and morphine milligram equivalents (MME)

    Measured: 1 day before the ontogenetic surgery, and at the time of discharge after postoperative management of the ontogenetic surgery assessed up to 60 months

  6. Time to normal bladder function

    In case of bladder preservation, normal bladder function is evaluated by residual urine check after time voiding, and the volume of residual urine is less than 100cc.

    The time from the ontogentic surgery to the time of confirmation or normal bladder function.

    Measured: The time from the ontogentic surgery to the time of confirmation or normal bladder function, assessed up to 60 months

Timeline

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

  1. First posted8 Dec 2016 (estimated)
  2. Study start10 May 2016
  3. Primary completion31 Dec 2025 (estimated)
  4. Study completion31 Dec 2025 (estimated)

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
380 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02986568
Sponsor's protocol ID
2015-1616
Acronym
FUSIONIV
Status last verified
Jul 2020
First submitted
16 Oct 2016
Last updated
24 Jul 2020
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Publications

  • Piver MS, Rutledge F, Smith JP. Five classes of extended hysterectomy for women with cervical cancer. Obstet Gynecol. 1974 Aug;44(2):265-72. No abstract available.

    PubMed 4417035
  • Querleu D, Morrow CP. Classification of radical hysterectomy. Lancet Oncol. 2008 Mar;9(3):297-303. doi: 10.1016/S1470-2045(08)70074-3.

    PubMed 18308255
  • Koh WJ, Greer BE, Abu-Rustum NR, Apte SM, Campos SM, Cho KR, Chu C, Cohn D, Crispens MA, Dorigo O, Eifel PJ, Fisher CM, Frederick P, Gaffney DK, Han E, Huh WK, Lurain JR 3rd, Mutch D, Fader AN, Remmenga SW, Reynolds RK, Teng N, Tillmanns T, Valea FA, Yashar CM, McMillian NR, Scavone JL. Cervical Cancer, Version 2.2015. J Natl Compr Canc Netw. 2015 Apr;13(4):395-404; quiz 404. doi: 10.6004/jnccn.2015.0055.

    PubMed 25870376
  • Koh WJ, Greer BE, Abu-Rustum NR, Apte SM, Campos SM, Chan J, Cho KR, Cohn D, Crispens MA, Dupont N, Eifel PJ, Fader AN, Fisher CM, Gaffney DK, George S, Han E, Huh WK, Lurain JR 3rd, Martin L, Mutch D, Remmenga SW, Reynolds RK, Small W Jr, Teng N, Tillmanns T, Valea FA, McMillian N, Hughes M. Uterine neoplasms, version 1.2014. J Natl Compr Canc Netw. 2014 Feb;12(2):248-80. doi: 10.6004/jnccn.2014.0025.

    PubMed 24586086
  • Fujii S. Anatomic identification of nerve-sparing radical hysterectomy: a step-by-step procedure. Gynecol Oncol. 2008 Nov;111(2 Suppl):S33-41. doi: 10.1016/j.ygyno.2008.07.026. Epub 2008 Aug 27.

    PubMed 18752840
  • Kim HS, Kim TH, Suh DH, Kim SY, Kim MA, Jeong CW, Hong KS, Song YS. Success Factors of Laparoscopic Nerve-sparing Radical Hysterectomy for Preserving Bladder Function in Patients with Cervical Cancer: A Protocol-Based Prospective Cohort Study. Ann Surg Oncol. 2015;22(6):1987-95. doi: 10.1245/s10434-014-4197-1. Epub 2014 Dec 3.

    PubMed 25465377
  • Kim HS, Kim K, Ryoo SB, Seo JH, Kim SY, Park JW, Kim MA, Hong KS, Jeong CW, Song YS; FUSION Study Group. Conventional versus nerve-sparing radical surgery for cervical cancer: a meta-analysis. J Gynecol Oncol. 2015 Apr;26(2):100-10. doi: 10.3802/jgo.2015.26.2.100.

    PubMed 25872891
  • Hockel M, Horn LC, Fritsch H. Association between the mesenchymal compartment of uterovaginal organogenesis and local tumour spread in stage IB-IIB cervical carcinoma: a prospective study. Lancet Oncol. 2005 Oct;6(10):751-6. doi: 10.1016/S1470-2045(05)70324-7. Epub 2005 Sep 8.

    PubMed 16198980
  • Hockel M. Laterally extended endopelvic resection. Novel surgical treatment of locally recurrent cervical carcinoma involving the pelvic side wall. Gynecol Oncol. 2003 Nov;91(2):369-77. doi: 10.1016/s0090-8258(03)00502-x.

    PubMed 14599868
  • Hockel M, Horn LC, Einenkel J. (Laterally) extended endopelvic resection: surgical treatment of locally advanced and recurrent cancer of the uterine cervix and vagina based on ontogenetic anatomy. Gynecol Oncol. 2012 Nov;127(2):297-302. doi: 10.1016/j.ygyno.2012.07.120. Epub 2012 Aug 1.

    PubMed 22864112
  • Hockel M, Horn LC, Manthey N, Braumann UD, Wolf U, Teichmann G, Frauenschlager K, Dornhofer N, Einenkel J. Resection of the embryologically defined uterovaginal (Mullerian) compartment and pelvic control in patients with cervical cancer: a prospective analysis. Lancet Oncol. 2009 Jul;10(7):683-92. doi: 10.1016/S1470-2045(09)70100-7. Epub 2009 May 29.

    PubMed 19482513
  • Hockel M, Hentschel B, Horn LC. Association between developmental steps in the organogenesis of the uterine cervix and locoregional progression of cervical cancer: a prospective clinicopathological analysis. Lancet Oncol. 2014 Apr;15(4):445-56. doi: 10.1016/S1470-2045(14)70060-9. Epub 2014 Mar 19.

    PubMed 24656439
  • Kimmig R, Aktas B, Buderath P, Wimberger P, Iannaccone A, Heubner M. Definition of compartment-based radical surgery in uterine cancer: modified radical hysterectomy in intermediate/high-risk endometrial cancer using peritoneal mesometrial resection (PMMR) by M Hockel translated to robotic surgery. World J Surg Oncol. 2013 Aug 16;11:198. doi: 10.1186/1477-7819-11-198.

    PubMed 23947937
  • Hockel M. Long-term experience with (laterally) extended endopelvic resection (LEER) in relapsed pelvic malignancies. Curr Oncol Rep. 2015 Mar;17(3):435. doi: 10.1007/s11912-014-0435-8.

    PubMed 25687807
  • Eisenhauer EA, Therasse P, Bogaerts J, Schwartz LH, Sargent D, Ford R, Dancey J, Arbuck S, Gwyther S, Mooney M, Rubinstein L, Shankar L, Dodd L, Kaplan R, Lacombe D, Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1). Eur J Cancer. 2009 Jan;45(2):228-47. doi: 10.1016/j.ejca.2008.10.026.

    PubMed 19097774

Questions about this trial

What is this clinical trial studying?

A study testing Cervical cancer, Uterine cancer and Cervical cancer, pelvic sidewall invasion in people with Cervical Cancer and Uterine Cancer, run by Seoul National University Hospital at 1 site in South Korea.

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 6 inclusion and 5 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 24 Jul 2020. 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 South Korea. 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 Hee Seung Kim, MD (82-2-2072-4863, bboddi0311@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Progression-free survival (time frame: From date of treatment start until the date of first documented progression or date of death (by any cause, in the absence of disease progression) whichever came first, assessed up to 60 months). The study lists 4 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 NCT02986568, which also lists 17 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 24 Jul 2020.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in