Complete Mesocolon Excision vs Locoregional Lymphadenectomy in Sigmoid Colon Cancer (CMELL)

NCT ID: NCT03083951

Last Updated: 2023-09-29

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

NA

Total Enrollment

93 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-09-01

Study Completion Date

2023-01-01

Brief Summary

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A randomized, controlled clinical trial comparing lymphadenectomy with extended inferior mesenteric artery ligation (complete mesocolon excision: which includes lymphoma tissue from the origin of the inferior mesenteric vein) with conventional locoregional lymphadenectomy in patients undergoing laparoscopic sigmoidectomy for sigmoid cancer.

Detailed Description

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Conditions

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Colorectal Cancer Sigmoid Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized controlled trial, single blind (the patient does not know the group to which it has been assigned) of patients undergoing laparoscopic sigmoid colon cancer resection. In all patients a lymphadenectomy with a high ligation of the Lower Mesenteric Artery will be performed. In patients in group 1A, lymphadenectomy will also include the lymphogranular tissue that accompanies the inferior mesenteric vein from its origin (complete mesocolon excision). In patients in group 1B, a conventional lymphadenectomy will be performed only from the origin of the inferior mesenteric artery without including the lymphatic tissue of the origin of the inferior mesenteric vein.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants
The patient does not know the group to which it has been assigned.

Study Groups

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Complete Mesocolon Excision

A high tie of the inferior mesenteric artery (IMA) should be attempted. The inferior mesenteric vein section at the Treitz angle should be performed. The lymphatic tissue that accompanies the inferior mesenteric vein should be added.

Group Type EXPERIMENTAL

Complete mesocolon excision

Intervention Type PROCEDURE

Laparoscopic sigmoidectomy with lymphadenectomy of the lymphatic tissue that accompanies the inferior mesenteric vein and a high tie ligation of the inferior mesenteric artery (complete mesocolon excision)

Conventional Locoregional Lymphadenectomy

A high tie of the inferior mesenteric artery (IMA) should be attempted. Lymphadenectomy of the lymphatic tissue that accompanies the IMA will be performed. The inferior mesenteric vein section could be performed at the discretion of the surgeon.

Group Type ACTIVE_COMPARATOR

Conventional locoregional lymphadenectomy

Intervention Type PROCEDURE

Laparoscopic sigmoidectomy with lymphadenectomy of the lymphatic tissue that accompanies the inferior mesenteric artery and a high tie ligation of the inferior mesenteric artery with or without section of inferior mesenteric vein.

Interventions

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Complete mesocolon excision

Laparoscopic sigmoidectomy with lymphadenectomy of the lymphatic tissue that accompanies the inferior mesenteric vein and a high tie ligation of the inferior mesenteric artery (complete mesocolon excision)

Intervention Type PROCEDURE

Conventional locoregional lymphadenectomy

Laparoscopic sigmoidectomy with lymphadenectomy of the lymphatic tissue that accompanies the inferior mesenteric artery and a high tie ligation of the inferior mesenteric artery with or without section of inferior mesenteric vein.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients undergoing programmed surgery for laparoscopic sigmoid colon cancer.
* Age ≥ 18 years and \<80 years.
* Histology of adenocarcinoma or adenoma without chemotherapy or neoadjuvant radiotherapy.
* Any T, any N, M0.
* Intention of resection R0.
* Informed consent signed by the patient and the investigator.

Exclusion Criteria

* Colorectal tumor with histology other than adenocarcinoma or adenoma.
* Colon cancer located in the right colon, transverse, splenic or non-sigmoid left colon.
* Metastatic disease (M1).
* History of colorectal cancer surgery, different from a local excision.
* Inflammatory bowel disease with anatomopathological confirmation.
* Patients with psychiatric illness, addiction or any disorder that impedes the understanding of informed consent.
* Inability to read or understand any of the languages of the informed consent (Catalan, Spanish).
* Another synchronous malignant disease.
* Emergency surgery.
Minimum Eligible Age

18 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pere Planellas Giné

OTHER

Sponsor Role lead

Responsible Party

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Pere Planellas Giné

Principal investigator

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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University Hospital Dr. Josep Trueta of Girona

Girona, , Spain

Site Status

Countries

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Spain

References

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Planellas P, Marinello F, Elorza G, Golda T, Farres R, Espin-Basany E, Enriquez-Navascues JM, Kreisler E, Cornejo L, Codina-Cazador A. Impact on defecatory, urinary and sexual function after high-tie sigmoidectomy: a post-hoc analysis of a multicenter randomized controlled trial comparing extended versus standard complete mesocolon excision. Langenbecks Arch Surg. 2023 Aug 1;408(1):293. doi: 10.1007/s00423-023-03026-9.

Reference Type DERIVED
PMID: 37526748 (View on PubMed)

Planellas P, Marinello F, Elorza G, Golda T, Farres R, Espin-Basany E, Enriquez-Navascues JM, Kreisler E, Cornejo L, Codina-Cazador A. Extended Versus Standard Complete Mesocolon Excision in Sigmoid Colon Cancer: A Multicenter Randomized Controlled Trial. Ann Surg. 2022 Feb 1;275(2):271-280. doi: 10.1097/SLA.0000000000005161.

Reference Type DERIVED
PMID: 34417367 (View on PubMed)

Other Identifiers

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13117

Identifier Type: -

Identifier Source: org_study_id

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