Trial Between Two Follow up Regimens With Different Test Intensity in Endometrial Cancer Treated Patients
NCT ID: NCT00916708
Last Updated: 2018-08-02
Study Results
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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UNKNOWN
NA
1884 participants
INTERVENTIONAL
2008-09-30
2020-12-31
Brief Summary
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If eligibility criteria are satisfied and the written informed consensus is obtained, patients are stratified inside the centre according to their risk level:
* Group 1 : patients at low risk of recurrence \[stage IA G1 and stage IA G2\]
* Group 2 : patients at high-risk of recurrence \[≥ stage IA G3\] (Ethics Committee amendment of 14th September 2010, use new 2010 FIGO classification for endometrial cancer!)
In each group patients will be randomized in two regimens of follow up:
1. Minimalist (Arm 1)
2. Intensive (Arm 2)
Features of each arm are listed in "Arms" item.
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Detailed Description
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In presence of symptoms or signs detected during the clinical visit which may suppose a recurrence or in presence of abnormal tests, the clinician has to prescribe all medical tests and examinations required. The tests carried out in addition to follow-up scheduled program must be reported in the database. Nevertheless patients continue to be followed for the assessment of the performance status at 5 years, but the follow-up schedule is up to the clinician. An interim analysis is scheduled in 3.5 years starting from the beginning of recruitment (based on approximately 1 / 3 of the total expected events, when about 4 / 5 cases have already been enrolled). Patients will be stratified by recruitment Center, by level of risk (calculated according to the stage of the disease, the histotype and the grading) and by type of treatment performed.
The focus of the study is to:
* Compare the effect of two FU regimens on 5-years OS
* Evaluate the difference in diagnosis anticipation
* Evaluate the difference in terms of recurrences
* Describe the compliance and QoL of patients
* Evaluate the cost-effectiveness and the cost-utility
Conditions
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Study Design
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RANDOMIZED
PARALLEL
OTHER
NONE
Study Groups
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Intensive follow up
Intensive follow up in low-risk patients Intensive follow up in high-risk patients
Intensive/Low-Risk follow up (IA G1; IA G2)
\- First 2 years of FU since the end of primary treatment: clinical visit\* every 4 months; Pap tests; chest, abdomen, pelvis CT every 12 months
\- Since the third to the fifth year of FU: clinical visit\* every 6 months; Pap test every 12 months
\* clinical visit with gynecological exploration
Intensive/High-Risk follow up (≥ IA G3)
\- First 3 years of FU since the end of primary treatment: clinical visit\*, Ca125, trans-vaginal and abdominal ultrasound every 4 months (except in conjunction with TC); Pap smear, abdomen, pelvis CT every 12 months
\- In the fourth and fifth years of FU: clinical visit\*, Ca125, trans-vaginal and abdominal ultrasound every 6 months (except in conjunction with TC) Pap smear; chest, abdomen, pelvis CT every 12 months
\* clinical visit with gynecological exploration
Minimalist follow up
Minimalist follow up in low-risk patients Minimalist follow up in high-risk patients
Minimalist/Low-Risk follow up (IA G1; IA G2)
\- First 5 years of FU since the end of primary treatment: clinical visit\* every 6 months.
\* clinical visit with gynecological exploration
Minimalist/High-Risk follow up (≥ IA G3)
\- First 2 years of FU since the end of primary treatment: clinical visit\* every 4 months; chest, abdomen, pelvis CT every 12 months
\- Since the third to the fifth year of surveillance: clinical visit\* every 6 months.
\* clinical visit with gynecological exploration
Interventions
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Intensive/Low-Risk follow up (IA G1; IA G2)
\- First 2 years of FU since the end of primary treatment: clinical visit\* every 4 months; Pap tests; chest, abdomen, pelvis CT every 12 months
\- Since the third to the fifth year of FU: clinical visit\* every 6 months; Pap test every 12 months
\* clinical visit with gynecological exploration
Intensive/High-Risk follow up (≥ IA G3)
\- First 3 years of FU since the end of primary treatment: clinical visit\*, Ca125, trans-vaginal and abdominal ultrasound every 4 months (except in conjunction with TC); Pap smear, abdomen, pelvis CT every 12 months
\- In the fourth and fifth years of FU: clinical visit\*, Ca125, trans-vaginal and abdominal ultrasound every 6 months (except in conjunction with TC) Pap smear; chest, abdomen, pelvis CT every 12 months
\* clinical visit with gynecological exploration
Minimalist/Low-Risk follow up (IA G1; IA G2)
\- First 5 years of FU since the end of primary treatment: clinical visit\* every 6 months.
\* clinical visit with gynecological exploration
Minimalist/High-Risk follow up (≥ IA G3)
\- First 2 years of FU since the end of primary treatment: clinical visit\* every 4 months; chest, abdomen, pelvis CT every 12 months
\- Since the third to the fifth year of surveillance: clinical visit\* every 6 months.
\* clinical visit with gynecological exploration
Eligibility Criteria
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Inclusion Criteria
* no previous or concurrent neoplasia (with the exception of carcinoma in situ of the cervix and basalioma of the skin)
* other contemporaneous RCT may be allowed if there is not any restriction concerning follow up
* obtaining a written informed consensus before randomization
* age \> 18 years
Exclusion Criteria
* previous, concurrent or second malignancies endometrial carcinoma in the context of a hereditary syndrome
* conditions which contraindicate medical tests scheduled according to follow-up regimen
18 Years
FEMALE
No
Sponsors
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Centro di Riferimento per l'Epidemiologia e la Prev. Oncologica Piemonte
OTHER
Rete Oncologica Piemonte, Valle d'Aosta
OTHER
Azienda Ospedaliera San Giovanni Battista
OTHER
Responsible Party
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Paolo Zola
Paolo Zola MD, Study Coordinator
Principal Investigators
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Paolo Zola, MD
Role: PRINCIPAL_INVESTIGATOR
Azienda Ospedaliera Città della Salute e della Scienza di Torino - University of Turin
Locations
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Azienda Ospedaliera Città della Salute e della Scienza di Torino
Turin, , Italy
Countries
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References
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Gadducci A, Fuso L, Cosio S, Landoni F, Maggino T, Perotto S, Sartori E, Testa A, Galletto L, Zola P. Are surveillance procedures of clinical benefit for patients treated for ovarian cancer?: A retrospective Italian multicentric study. Int J Gynecol Cancer. 2009 Apr;19(3):367-74. doi: 10.1111/IGC.0b013e3181a1cc02.
Zanagnolo V, Minig LA, Gadducci A, Maggino T, Sartori E, Zola P, Landoni F. Surveillance procedures for patients for cervical carcinoma: a review of the literature. Int J Gynecol Cancer. 2009 Apr;19(3):306-13. doi: 10.1111/IGC.0b013e3181a130f3.
Zola P, Fuso L, Mazzola S, Piovano E, Perotto S, Gadducci A, Galletto L, Landoni F, Maggino T, Raspagliesi F, Sartori E, Scambia G. Could follow-up different modalities play a role in asymptomatic cervical cancer relapses diagnosis? An Italian multicenter retrospective analysis. Gynecol Oncol. 2007 Oct;107(1 Suppl 1):S150-4. doi: 10.1016/j.ygyno.2007.07.028. Epub 2007 Sep 14.
Zola P, Fuso L, Mazzola S, Gadducci A, Landoni F, Maggino T, Sartori E. Follow-up strategies in gynecological oncology: searching appropriateness. Int J Gynecol Cancer. 2007 Nov-Dec;17(6):1186-93. doi: 10.1111/j.1525-1438.2007.00943.x. Epub 2007 Apr 26.
Gadducci A, Cosio S, Zola P, Landoni F, Maggino T, Sartori E. Surveillance procedures for patients treated for epithelial ovarian cancer: a review of the literature. Int J Gynecol Cancer. 2007 Jan-Feb;17(1):21-31. doi: 10.1111/j.1525-1438.2007.00826.x.
Rosato R, Ferrero A, Mosconi P, Ciccone G, Di Cuonzo D, Evangelista A, Fuso L, Piovano E, Pagano E, Laudani ME, Pace L, Zola P; TOTEM Collaborative Group. Impact of different follow-up regimens on health-related quality of life and costs in endometrial cancer patients: Results from the TOTEM randomized trial. Gynecol Oncol. 2024 May;184:150-159. doi: 10.1016/j.ygyno.2024.01.050. Epub 2024 Feb 3.
Zola P, Ciccone G, Piovano E, Fuso L, Di Cuonzo D, Castiglione A, Pagano E, Peirano E, Landoni F, Sartori E, Narducci F, Bertetto O, Ferrero A; TOTEM Collaborative Group. Effectiveness of Intensive Versus Minimalist Follow-Up Regimen on Survival in Patients With Endometrial Cancer (TOTEM Study): A Randomized, Pragmatic, Parallel Group, Multicenter Trial. J Clin Oncol. 2022 Nov 20;40(33):3817-3827. doi: 10.1200/JCO.22.00471. Epub 2022 Jul 20.
Related Links
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The recruitment of patients has to be registered on the website (http://www.epiclin.it). On the website patients are randomized and crf are available to register follow up appointment
Other Identifiers
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TOTEM
Identifier Type: -
Identifier Source: org_study_id
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