J-Pouch Coloanal Anastomosis Compared With Side-to-End Coloanal Anastomosis After Radiation Therapy and Surgery to Remove the Rectum in Treating Patients With Rectal Adenocarcinoma

NCT ID: NCT00070005

Last Updated: 2013-08-07

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2002-06-30

Brief Summary

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RATIONALE: A coloanal anastomosis may be effective in restoring bowel function after radiation therapy and surgery to remove the rectum. It is not yet known whether a J-pouch coloanal anastomosis is more effective than a side-to-end coloanal anastomosis in restoring bowel function in patients with rectal adenocarcinoma who have undergone radiation therapy and surgery to remove the rectum.

PURPOSE: This randomized phase III trial is studying how well J-pouch coloanal anastomosis works compared to side-to-end coloanal anastomosis in treating patients with rectal adenocarcinoma who have undergone radiation therapy and surgery to remove the rectum.

Detailed Description

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OBJECTIVES:

Primary

* Compare functional outcome in patients with mid- or distal rectal adenocarcinoma when treated with J-pouch coloanal anastomosis vs side-to-end coloanal anastomosis after preoperative radiotherapy and total mesorectal excision.

Secondary

* Compare the quality of life of patients treated with these procedures.
* Compare anorectal function in patients treated with these procedures.

OUTLINE: This is a randomized, multicenter study. Patients are stratified according to participating center and gender. Patients are randomized to 1 of 2 treatment arms.

* Arm I: Patients undergo total mesorectal excision followed by a J-pouch coloanal anastomosis.
* Arm II: Patients undergo total mesorectal excision followed by a side-to-end coloanal anastomosis.

In both arms, patients receive a temporary ileostomy. The ileostomy is closed after 1 week provided recovery is uneventful and no radiological signs of anastomotic leakage are detected. If early closure is not possible, the ileostomy is closed after 6-8 weeks.

Functional outcome, quality of life, and anorectal function are assessed before surgery and at 4 and 12 months after surgery.

PROJECTED ACCRUAL: A minimum of 100 patients (50 per treatment arm) will be accrued for this study.

Conditions

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Colorectal Cancer Perioperative/Postoperative Complications

Keywords

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perioperative/postoperative complications stage I rectal cancer stage II rectal cancer stage III rectal cancer adenocarcinoma of the rectum

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

SUPPORTIVE_CARE

Interventions

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conventional surgery

Intervention Type PROCEDURE

management of therapy complications

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

DISEASE CHARACTERISTICS:

* Histologically confirmed adenocarcinoma of the rectum

* T2 or T3 disease
* Disease located in the mid- or distal rectum
* No evidence of metastatic disease
* No preexisting grade III or IV incontinence
* Completed preoperative radiotherapy (5 x 5 Gy) before study entry

PATIENT CHARACTERISTICS:

Age

* Over 18

Performance status

* WHO 0-2

Life expectancy

* Not specified

Hematopoietic

* Not specified

Hepatic

* Not specified

Renal

* Not specified

Other

* Working knowledge of the Dutch language

PRIOR CONCURRENT THERAPY:

Biologic therapy

* Not specified

Chemotherapy

* No prior chemotherapy

Endocrine therapy

* Not specified

Radiotherapy

* See Disease Characteristics
* No prior radiotherapy to the pelvis

Surgery

* No prior colon resection
* No prior anorectal surgery
* No concurrent abdominoperineal resection
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

OTHER

Sponsor Role lead

Principal Investigators

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Roel Bakx, MD

Role: STUDY_CHAIR

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Locations

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Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital

Amsterdam, , Netherlands

Site Status

St. Lucas - Andreas Ziekenhuis

Amsterdam, , Netherlands

Site Status

Onze Lieve Vrouwe Gasthuis

Amsterdam, , Netherlands

Site Status

Academisch Medisch Centrum at University of Amsterdam

Amsterdam, , Netherlands

Site Status

Gelre Ziekenhuizen - Lokatie Lukas

Apeldoorn, , Netherlands

Site Status

Reinier de Graaf Group - Delft

Delft, , Netherlands

Site Status

Albert Schweitzerziekenhuis - Locatie Amstelwijck

Dordrecht NM, , Netherlands

Site Status

Isala Klinieken - locatie Sophia

Zwolle, , Netherlands

Site Status

Isala Klinieken - locatie Weezenlanden

Zwolle, , Netherlands

Site Status

Countries

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Netherlands

Other Identifiers

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CDR0000328269

Identifier Type: REGISTRY

Identifier Source: secondary_id

EU-20247

Identifier Type: -

Identifier Source: secondary_id

CKTO-2002-02-POCASTER

Identifier Type: -

Identifier Source: org_study_id