Laparoscopic vs Open Pancreatectomy for Body and Tail Pancreatic Cancer

NCT ID: NCT03792932

Last Updated: 2022-06-22

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

NA

Total Enrollment

306 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-02-02

Study Completion Date

2023-01-31

Brief Summary

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Open distal pancreatectomy (ODP) has been commonly employed for the treatment of a variety of cancers in body and tail of pancreas. Although many general surgical procedures have been increasingly performed laparoscopically or with laparoscopic assistance, until the current decade, laparoscopic pancreatic surgery had not been performed for its complicated anatomy. But laparoscopic distal pancreatectomy (LDP) has been widely accepted as a standard treatment for body and tail pancreatic cancer because there is no anastomosis in it, and LDP has gradually become the first choice for these cancers in clinical work. Although there are several studies about the comparison between LDP and ODP, most are retrospective and there is no agreement in surgical margin, lymph node numbers and prognosis to identify the oncological differences between the two surgical approaches. The investigators' pilot study showed that patients with body and tail pancreatic cancer underwent LDP had a better prognosis compared with the ones undergoing ODP, with no statistics differences in postoperative complications and mortality. This perspective RCT study is performed to confirm whether LDP would improve the prognosis for patients with body and tail pancreatic cancer compared with ODP.

Detailed Description

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Conditions

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Pancreatic Cancer Surgery Laparoscopy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Laparoscopic distal pancreatectomy

Group Type ACTIVE_COMPARATOR

Laparoscopic distal pancreatectomy

Intervention Type PROCEDURE

Laparoscopic distal pancreatectomy includes distal pancreatectomy, splenectomy, and regional lymph nodes resection for pancreatic cancer at the body and tail. Regional lymph nodes includes group 8, 10, 11, 18, 7, 9, 14, 15, according to the 2003 edition of lymph nodes group system defined by Japan Pancreas Society (JPS).

Open distal pancreatectomy

Group Type ACTIVE_COMPARATOR

Open distal pancreatectomy

Intervention Type PROCEDURE

Open distal pancreatectomy includes distal pancreatectomy, splenectomy, and regional lymph nodes resection for pancreatic cancer at the body and tail. Regional lymph nodes includes group 8, 10, 11, 18, 7, 9, 14, 15, according to the 2003 edition of lymph nodes group system defined by Japan Pancreas Society (JPS).

Interventions

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Laparoscopic distal pancreatectomy

Laparoscopic distal pancreatectomy includes distal pancreatectomy, splenectomy, and regional lymph nodes resection for pancreatic cancer at the body and tail. Regional lymph nodes includes group 8, 10, 11, 18, 7, 9, 14, 15, according to the 2003 edition of lymph nodes group system defined by Japan Pancreas Society (JPS).

Intervention Type PROCEDURE

Open distal pancreatectomy

Open distal pancreatectomy includes distal pancreatectomy, splenectomy, and regional lymph nodes resection for pancreatic cancer at the body and tail. Regional lymph nodes includes group 8, 10, 11, 18, 7, 9, 14, 15, according to the 2003 edition of lymph nodes group system defined by Japan Pancreas Society (JPS).

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 19 years and ≤ 80 years, no gender limitation
2. Resectable body and tail pancreatic cancer (refer to NCCN 2018)
3. Eastern Cooperative Oncology Group (ECOG) performance status 0-1
4. Tumor locates at the body and tail of the pancreas without distant metastasis
5. No celiac trunk and superior mesenteric artery invasion
6. No operation contraindication, fit for laparoscopic surgery
7. The expected survival after surgery ≥ 3 months
8. Patients who are willing and able to comply with the study procedure
9. Signed informed content obtained prior to treatment

Exclusion Criteria

1. Locally advanced unresectable body and tail pancreatic cancer
2. Multi-organ and vascular resection needed
3. Patients undergoing total pancreatectomy
4. Benign tumor at the body and tail of the pancreas or pancreatic cancer at the head of the pancreas
5. Distant metastasis or ascites detected by imaging
6. Severe important organ function impairment (heart, liver, kidney)
7. Patients who are with other primary malignancy or haematological disorders
8. Pregnant or nursing women
9. Patients who have received chemotherapy, radiotherapy and interventional therapy before the pancreatectomy
10. Patients who have participated in other clinical trials for pancreatic cancer treatment within 3 months
Minimum Eligible Age

19 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fudan University

OTHER

Sponsor Role lead

Responsible Party

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Xian-Jun Yu

Chair of Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center; Pancreatic Cancer Institute, Fudan University

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital)

Hefei, Anhui, China

Site Status RECRUITING

Department of Hepatobiliary and Pancreatic Surgery, The Second Hospital of Hebei Medical University

Shijiazhuang, Hebei, China

Site Status RECRUITING

Department of Hepatopancreatobiliary Surgery, Second Affiliated Hospital of Harbin Medical University,

Harbin, Heilongjiang, China

Site Status RECRUITING

Department of Biliary-Pancreatic Surgery, Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology

Wuhan, Hubei, China

Site Status RECRUITING

Department of Hepato-Pancreato-Biliary Surgery, The Affiliated Hospital of Xuzhou Medical University

Xuzhou, Jiangsu, China

Site Status RECRUITING

Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center; Shanghai Pancreatic Cancer Institute; Pancreatic Cancer Institute, Fudan University. Shanghai, China

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Shanghai Changzheng Hospital

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

West China Hospital

Chengdu, Sichuan, China

Site Status RECRUITING

Department of Gastroenterology and Pancreatic Surgery, Zhejiang Provincial People's Hospital

Hanzhou, Zhejiang, China

Site Status RECRUITING

Department of Pancreatic and Biliary Surgery, The First Affiliated Hospital of Harbin Medical University

Harbin, , China

Site Status RECRUITING

Department of Biliopancreatic Surgery, Huadong Hospital, Fudan University

Shanghai, , China

Site Status RECRUITING

Countries

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China

Central Contacts

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Xianjun Yu, M.D., Ph.D.

Role: CONTACT

+86-21-64175590 ext. 1307

He Cheng, M.D., Ph.D.

Role: CONTACT

+86-21-64175590 ext. 1307

Facility Contacts

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chenlin zhu

Role: primary

Jianhua Liu

Role: primary

Zhidong Wang

Role: primary

Renyi Qin, PHD

Role: primary

Wenxing Zhao

Role: primary

Xianjun Yu, M.D., Ph.D.

Role: primary

+86-21-6417-5590 ext. 1307

He Cheng, M.D., Ph.D.

Role: backup

+86-21-6417-5590 ext. 1307

Liang Tang, Dr.

Role: primary

13918874380

Yunqiang Cai, Dr.

Role: primary

17721950223

Weiwei Jin

Role: primary

Hua Chen

Role: primary

Wei Wang

Role: primary

References

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Ricci C, Casadei R, Taffurelli G, Toscano F, Pacilio CA, Bogoni S, D'Ambra M, Pagano N, Di Marco MC, Minni F. Laparoscopic versus open distal pancreatectomy for ductal adenocarcinoma: a systematic review and meta-analysis. J Gastrointest Surg. 2015 Apr;19(4):770-81. doi: 10.1007/s11605-014-2721-z. Epub 2015 Jan 6.

Reference Type BACKGROUND
PMID: 25560180 (View on PubMed)

van Hilst J, de Rooij T, Klompmaker S, Rawashdeh M, Aleotti F, Al-Sarireh B, Alseidi A, Ateeb Z, Balzano G, Berrevoet F, Bjornsson B, Boggi U, Busch OR, Butturini G, Casadei R, Del Chiaro M, Chikhladze S, Cipriani F, van Dam R, Damoli I, van Dieren S, Dokmak S, Edwin B, van Eijck C, Fabre JM, Falconi M, Farges O, Fernandez-Cruz L, Forgione A, Frigerio I, Fuks D, Gavazzi F, Gayet B, Giardino A, Groot Koerkamp B, Hackert T, Hassenpflug M, Kabir I, Keck T, Khatkov I, Kusar M, Lombardo C, Marchegiani G, Marshall R, Menon KV, Montorsi M, Orville M, de Pastena M, Pietrabissa A, Poves I, Primrose J, Pugliese R, Ricci C, Roberts K, Rosok B, Sahakyan MA, Sanchez-Cabus S, Sandstrom P, Scovel L, Solaini L, Soonawalla Z, Souche FR, Sutcliffe RP, Tiberio GA, Tomazic A, Troisi R, Wellner U, White S, Wittel UA, Zerbi A, Bassi C, Besselink MG, Abu Hilal M; European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS). Minimally Invasive versus Open Distal Pancreatectomy for Ductal Adenocarcinoma (DIPLOMA): A Pan-European Propensity Score Matched Study. Ann Surg. 2019 Jan;269(1):10-17. doi: 10.1097/SLA.0000000000002561.

Reference Type BACKGROUND
PMID: 29099399 (View on PubMed)

Sulpice L, Farges O, Goutte N, Bendersky N, Dokmak S, Sauvanet A, Delpero JR; ACHBT French Pancreatectomy Study Group. Laparoscopic Distal Pancreatectomy for Pancreatic Ductal Adenocarcinoma: Time for a Randomized Controlled Trial? Results of an All-inclusive National Observational Study. Ann Surg. 2015 Nov;262(5):868-73; discussion 873-4. doi: 10.1097/SLA.0000000000001479.

Reference Type BACKGROUND
PMID: 26583678 (View on PubMed)

Shin SH, Kim SC, Song KB, Hwang DW, Lee JH, Lee D, Lee JW, Jun E, Park KM, Lee YJ. A comparative study of laparoscopic vs. open distal pancreatectomy for left-sided ductal adenocarcinoma: a propensity score-matched analysis. J Am Coll Surg. 2015 Feb;220(2):177-85. doi: 10.1016/j.jamcollsurg.2014.10.014. Epub 2014 Oct 31.

Reference Type BACKGROUND
PMID: 25529901 (View on PubMed)

Venkat R, Edil BH, Schulick RD, Lidor AO, Makary MA, Wolfgang CL. Laparoscopic distal pancreatectomy is associated with significantly less overall morbidity compared to the open technique: a systematic review and meta-analysis. Ann Surg. 2012 Jun;255(6):1048-59. doi: 10.1097/SLA.0b013e318251ee09.

Reference Type BACKGROUND
PMID: 22511003 (View on PubMed)

Liu C, Cheng H, Wang M, Cai Y, Jiang C, Tang L, Luo G, Jin K, Ji S, Xu W, Shi S, Wang X, Liu M, Zhao W, Xu X, Xu J, Wu W, Wang W, Liu J, Shao C, Peng B, Qin R, Yu X; Chinese Study Group for Pancreatic Cancer (CSPAC). Effect of Laparoscopic versus Open Distal Pancreatectomy on Recurrence-Free Survival in Patients with Left-sided Pancreatic Cancer: A randomized controlled trial. Ann Surg. 2025 Feb 25. doi: 10.1097/SLA.0000000000006681. Online ahead of print.

Reference Type DERIVED
PMID: 39996303 (View on PubMed)

Other Identifiers

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CSPAC-2

Identifier Type: -

Identifier Source: org_study_id

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