Benefit of a Flash Dose of Corticosteroids in Digestive Surgical Oncology: a Randomized, Double Blind, Placebo-controlled Trial

NCT ID: NCT03875690

Last Updated: 2024-12-03

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

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

1200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-07-02

Study Completion Date

2027-09-30

Brief Summary

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Perioperative inflammation is harmful in cancer patients, namely in those undergoing surgery: it increases the risk of recurrence, decreases cancer survival, increases post-operative complications, and prolongs the time of recovery and the duration of hospital stay. Severe postoperative complications are also a risk factor of poor survival in cancer patients. Seemingly, some effective therapies currently used to improve the surgical outcome (e.g. immunonutrition, enhanced-recovery protocols) have an inflammatory effect. The modulation of perioperative inflammation therefore seems crucial to improve outcomes in patients undergoing surgery for digestive cancer.

A short perioperative treatment with high doses of corticosteroids has already been tested in several randomized trials. A recent meta-analysis showed that perioperative corticosteroids decreased inflammatory markers and might be associated with fewer complications in esophageal, liver, pancreatic and colorectal surgery: the decrease in the risk of postoperative complications was around 50% without adverse effects.

Detailed Description

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Conditions

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Elective Surgery for Any Digestive Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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Experimental group

Group Type EXPERIMENTAL

Injection of methylprednisolone

Intervention Type DRUG

Patients will receive 20mg/kg IV of methylprednisolone at the time of anaesthetic induction. Methylprednisolone will be infused in a ready-to-use 50 mL bag of sodium chloride 0.9% during 30 minutes at anaesthesic induction.

Blood samples

Intervention Type BIOLOGICAL

electrolyte panel and glycemia performed within the first 24 hours after surgery.

Control group

Group Type PLACEBO_COMPARATOR

Injection of sodium chloride

Intervention Type DRUG

patients in the placebo group will receive 50 mL of sodium chloride 0.9% in a ready-to-use bag during 30 minutes at anaesthesic induction.

Blood samples

Intervention Type BIOLOGICAL

electrolyte panel and glycemia performed within the first 24 hours after surgery.

Interventions

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Injection of methylprednisolone

Patients will receive 20mg/kg IV of methylprednisolone at the time of anaesthetic induction. Methylprednisolone will be infused in a ready-to-use 50 mL bag of sodium chloride 0.9% during 30 minutes at anaesthesic induction.

Intervention Type DRUG

Injection of sodium chloride

patients in the placebo group will receive 50 mL of sodium chloride 0.9% in a ready-to-use bag during 30 minutes at anaesthesic induction.

Intervention Type DRUG

Blood samples

electrolyte panel and glycemia performed within the first 24 hours after surgery.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Age \>\_18 years
* Elective surgery for any digestive cancer (except purely hepatic surgery)
* Patients operated in a curative intent
* Patients who had given their written informed consent
* Patients affiliated to a National health insurance scheme

Exclusion Criteria

* Emergency surgery
* Pregnant or breastfeeding women
* Patients with an ongoing oral treatment by steroids
* Palliative surgery
* Exclusive liver surgery
* Concomitant hyperthermic intraperitoneal chemotherapy
* Patient with at least one contra-indication to methylprednisolone treatment :
* active infection
* progressive/symptomatic viral infection (particularly hepatitis, herpes, chickenpox, herpes zoster)
* uncontrolled psychotic state
* hypersensitivity to methylprednisolone or to one of its excipients
* ASA grade \>3
* Persons subject to a measure of legal protection (guardianship, tutorship)
* Persons subject to a court order
* Impossibility to adhere to the medical follow-up of the trial for geographical, social or psychological reasons
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Centre Hospitalier Universitaire Dijon

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Chu de Dijon

Dijon, , France

Site Status

Countries

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France

References

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Magnin J, Fournel I, Doussot A, Regimbeau JM, Zerbib P, Piessen G, Beyer-Berjot L, Deguelte S, Lakkis Z, Schwarz L, Orry D, Ayav A, Muscari F, Mauvais F, Passot G, Trelles N, Venara A, Benoist S, Messager M, Fuks D, Borraccino B, Tresallet C, Valverde A, Souche FR, Herrero A, Gaujoux S, Lefevre J, Bourredjem A, Cransac A, Ortega-Deballon P. Benefit of a flash dose of corticosteroids in digestive surgical oncology: a multicenter, randomized, double blind, placebo-controlled trial (CORTIFRENCH). BMC Cancer. 2022 Aug 23;22(1):913. doi: 10.1186/s12885-022-09998-z.

Reference Type DERIVED
PMID: 35999521 (View on PubMed)

Other Identifiers

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ORTEGA PHRCK 2017

Identifier Type: -

Identifier Source: org_study_id