Local Excision in Downstaged Rectal Cancer

NCT ID: NCT00427375

Last Updated: 2018-03-14

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

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

148 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-03-05

Study Completion Date

2018-02-08

Brief Summary

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Patients with T2T3 low rectal cancer (size =\< 4 cm) received neoadjuvant treatment (50Gy in 5 weeks with concomitant chemotherapy. Good responders (residual tumour =\< 2 cm) are randomised in local vs rectal excision, 6-8 weeks after treatment. The composite end point evaluates the rate of patients with death, recurrence, major morbidity or severe after effects at two years.

Detailed Description

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Rectal excision is the standard surgical treatment of rectal cancer. The risk of mortality and major short and long term morbidity induced by rectal excision justifies new treatments. Local excision is a conservative alternative approach associated with low mortality and morbidity. The purpose of this prospective randomised multicenter study is to compare local vs rectal excision in good responders after radiochemotherapy for low rectal cancer.

Patients with T2T3 low rectal cancer, less than 8 cm from the anal verge, size =\< 4 cm, received neoadjuvant treatment, included radiotherapy between 45-55Gy in 5 weeks with concomitant chemotherapy consist of at least, one fluoropyrimidine.

Good clinical responders (residual tumour =\< 2 cm) are randomised in local vs rectal excision, 6-8 weeks after treatment. In case of not confirmed pathological response following local excision, complementary rectal excision is required.

Bad responders (residual tumour \> 2cm) are treated by primary rectal excision. Follow-up includes digital rectal examination, CT-scan and endorectal ultrasound (if local excision) every 4 months for 2 years, then every 6 months for 3 years.

Conditions

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Rectal Neoplasms

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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1

New surgical option in good responders after neoadjuvant treatment for low rectal cancer

Group Type EXPERIMENTAL

local rectal excision

Intervention Type PROCEDURE

New surgical option in good responders after neoadjuvant treatment for low rectal cancer

2

Standard surgery

Group Type ACTIVE_COMPARATOR

total mesorectal excision

Intervention Type PROCEDURE

standard surgery

Interventions

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local rectal excision

New surgical option in good responders after neoadjuvant treatment for low rectal cancer

Intervention Type PROCEDURE

total mesorectal excision

standard surgery

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* T2T3 low adenocarcinoma of the rectum
* Tumour size =\< 4cm
* Less than 8 cm from the anal verge
* No metastatic disease
* Patient is at least 18 years of age
* ECOG performance status score =\< 2
* Patient and doctor have signed informed consent

Exclusion Criteria

* T1, T4 tumour or anal sphincter invasion
* Metastatic disease (M1)
* Contra indication for radiotherapy and/or fluoropyrimidine use in chemotherapy
* History of cancer
* Symptomatic cardiac or coronary insufficiency
* Severe renal insufficiency
* Peripheral neuropathy
* Patient included in a trial
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sanofi

INDUSTRY

Sponsor Role collaborator

Roche Pharma AG

INDUSTRY

Sponsor Role collaborator

University Hospital, Bordeaux

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Eric RULLIER, Pr.

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Bordeaux

Locations

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Centre Radiothérapie Oncologie Moyenne Garonne - 13 Quai du Docteur Calabet

Agen, , France

Site Status

Polyclinique Sainte marguerite

Auxerre, , France

Site Status

Service de Chirurgie Viscérale, Digestive et Cancérologique - CHRU J.Minoz - Boulevard Fleming

Besançon, , France

Site Status

Service de Radiothérapie - Clinique Tivoli - 220 rue Mandron

Bordeaux, , France

Site Status

Service de chirurgie digestive - hôpital Saint André - 1 rue Jean Burguet

Bordeaux, , France

Site Status

Service de Chirurgie Oncologique - Institut Bergonié - 229, cours de l'Argonne

Bordeaux, , France

Site Status

Service de Chirurgie Digestive - Hôpital ambroise Paré - 9 avenue Charles de Gaulle

Boulogne-Billancourt, , France

Site Status

Service de Chirurgie Générale et Digestive - Hôtel Dieu - CHU Clermont-Ferrand - Boulevard Léon Malfreyt

Clermont-Ferrand, , France

Site Status

Département de Radiothérapie - Centre Jean Perrin - 58 rue Montalembert

Clermont-Ferrand, , France

Site Status

Service de Chirurgie Générale et Digestive - Hôpital Beaujon - 100 boulevard du Général Leclerc

Clichy, , France

Site Status

Centre d'Oncologie et Radiothérapie - rue du Dr Schweitzer

La Rochelle, , France

Site Status

Service de Chirurgie Digestive - Hôpital A. Michallon - CHU de Grenoble - Boulevard de la Chantourne

La Tronche, , France

Site Status

Département de Chirurgie Oncologique - Centre Oscar Lambret - 3 rue Combemale

Lille, , France

Site Status

Service de Chirurgie Générale - Hôpitaux Civils de Lyon

Lyon, , France

Site Status

Département de Chirurgie Oncologique - Centre Léon Bérard - 28 rue Laennec

Lyon, , France

Site Status

Institut Paoli Calmette

Marseille, , France

Site Status

Service de Chirurgie Digestive et viscérale - CHU Timone - 264 rue Saint Pierre

Marseille, , France

Site Status

Département de Chirurgie Oncologique - CRLC Val d'Aurelle

Montpellier, , France

Site Status

CHU Nantes

Nantes, , France

Site Status

Service d'Oncologie-Radiothérapie - Centre antoine Lacassagne - 33 avenue de Valombrose

Nice, , France

Site Status

Service de Chirurgie Générale - Hôpital Archet II

Nice, , France

Site Status

CHU Nîmes

Nîmes, , France

Site Status

Département Médico-Chirurgical de Pathologie Digestive - Hôpital Lariboisière - 2 rue Ambroise Paré

Paris, , France

Site Status

Service de Cancérologie - Radiothérapie - Hôpital Saint-Louis - 1 avenue Claude Vellefeaux

Paris, , France

Site Status

Service de Chirurgie Digestive - Hôpital des Diaconnesses - la Croix Saint-Simon - 125 rue d'Avron

Paris, , France

Site Status

Service de Chirurgie Générale et Digestive - Hôpital Saint-Antoine - 184 rue du Faubourg Saint-Antoine

Paris, , France

Site Status

Service d'Oncologie - Radiothérapie - Hôpital Tenon - 4 rue de la Chine

Paris, , France

Site Status

Service de Radiothérapie - Oncologie - Centre Hospitalier Lyon Sud - Hôpitaux Civils de Lyon - 165 chemin du Grand Revoyet

Pierre-Bénite, , France

Site Status

Service de Chirurgie Viscérale - CHU pontchaillou - 2 rue Henri Le Guilloux

Rennes, , France

Site Status

Département des Radiations - Centre Eugène Marquis - rue de la Bataille Flandres-Dunkerque

Rennes, , France

Site Status

Service de Chirurgie Digestive - CHU Charles Nicolle - 1 rue Germont

Rouen, , France

Site Status

Service de Radiothérapie-Oncologie - centre Henri Becquerel - rue d'Amiens

Rouen, , France

Site Status

Service de Chirurgie Oncologique - Centre René Gauducheau - Boulevard Jacques Monod

Saint-Herblain, , France

Site Status

Service de Chirurgie Viscérale - Clinique Charcot - 51-52 rue Commandant Charcot

Sainte-Foy-lès-Lyon, , France

Site Status

Département de Radiothérapie - Centre Paul Strauss - 3 rue de la Porte de l'Hôpital

Strasbourg, , France

Site Status

Service de Chirurgie Digestive - Hôpital Hautepierre

Strasbourg, , France

Site Status

Département d'Oncologie Médicale - Institut Claudius Régaud - 20-24 rue du Pont Saint Pierre

Toulouse, , France

Site Status

Service de Chirurgie Digestive - Hôpital Purpan - Place du Docteur Baylac

Toulouse, , France

Site Status

Département de Chirurgie Oncologique - Centre Alexis Vautrin - Avenue de Bourgogne

Vandœuvre-lès-Nancy, , France

Site Status

Service de Chirurgie Digestive et Générale - CHU Brabois - avenue de Bourgogne

Vandœuvre-lès-Nancy, , France

Site Status

Countries

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France

References

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Teste B, Rouanet P, Tuech JJ, Valverde A, Lelong B, Rivoire M, Faucheron JL, Jafari M, Portier G, Meunier B, Sielezneff I, Prudhomme M, Marchal F, Dubois A, Capdepont M, Denost Q, Rullier E. Early and late morbidity of local excision after chemoradiotherapy for rectal cancer. BJS Open. 2021 May 7;5(3):zrab043. doi: 10.1093/bjsopen/zrab043.

Reference Type DERIVED
PMID: 34097005 (View on PubMed)

Rullier E, Vendrely V, Asselineau J, Rouanet P, Tuech JJ, Valverde A, de Chaisemartin C, Rivoire M, Trilling B, Jafari M, Portier G, Meunier B, Sieleznieff I, Bertrand M, Marchal F, Dubois A, Pocard M, Rullier A, Smith D, Frulio N, Frison E, Denost Q. Organ preservation with chemoradiotherapy plus local excision for rectal cancer: 5-year results of the GRECCAR 2 randomised trial. Lancet Gastroenterol Hepatol. 2020 May;5(5):465-474. doi: 10.1016/S2468-1253(19)30410-8. Epub 2020 Feb 7.

Reference Type DERIVED
PMID: 32043980 (View on PubMed)

Rullier E, Rouanet P, Tuech JJ, Valverde A, Lelong B, Rivoire M, Faucheron JL, Jafari M, Portier G, Meunier B, Sileznieff I, Prudhomme M, Marchal F, Pocard M, Pezet D, Rullier A, Vendrely V, Denost Q, Asselineau J, Doussau A. Organ preservation for rectal cancer (GRECCAR 2): a prospective, randomised, open-label, multicentre, phase 3 trial. Lancet. 2017 Jul 29;390(10093):469-479. doi: 10.1016/S0140-6736(17)31056-5. Epub 2017 Jun 7.

Reference Type DERIVED
PMID: 28601342 (View on PubMed)

Other Identifiers

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2005-025

Identifier Type: -

Identifier Source: secondary_id

CHUBX 2006/03

Identifier Type: -

Identifier Source: org_study_id

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