Prophylactic Surgery Plus HIPEC With CO2 in Patients Affected by Gastric Carcinoma.GOETH Study

NCT ID: NCT03917173

Last Updated: 2023-10-26

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

240 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-06-01

Study Completion Date

2025-06-01

Brief Summary

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This is a phase III randomized, multicenter study with two different arm:

* experimental: prophylactic surgery plus HIPEC CO2 performed with mitomycin and cisplatin
* comparator: standard surgery

Adjuvant treatment after surgery is mandatory except for documented cases of non-eligibility in both arms.

Patient will be randomized in a 1:1 ratio. Randomization will be performed during surgery if the total resection of tumor will be reached according to center and neoadjuvant chemotherapy as stratification variables.

Detailed Description

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This is a phase III randomized, multicenter study with two different arm:

* experimental: prophylactic surgery plus HIPEC CO2 performed with mitomycin and cisplatin
* comparator: standard surgery Adjuvant treatment after surgery is mandatory except for documented cases of non-eligibility.

Patient will be randomized in a 1:1 ratio. Randomization will be performed during surgery if the total resection of tumor will be reached according to center and neoadjuvant chemotherapy as stratification variables.

The primary objective of the study is to compare the efficacy of prophylactic surgery (radical gastric resection, appendectomy, round ligament of the liver resection and bilateral adnexectomy) plus HIPEC CO2 versus standard surgery in terms of disease free survival (DFS).

Patients affected by gastric carcinoma at high risk of developing peritoneal carcinomatosis will be randomized in this study.

Conditions

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Stomach Neoplasms

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a phase III randomized, multicenter study with two different arm:

* experimental: prophylactic surgery plus HIPEC CO2 performed with mitomycin and cisplatin
* comparator: standard surgery
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Experimental

Prophylactic surgery plus HIPEC CO2 performed with mitomycin and cisplatin

Group Type EXPERIMENTAL

Surgery plus HIPEC CO2

Intervention Type PROCEDURE

Prophylactic surgery plus HIPEC CO2 performed with mitomycin and cisplatin v

Comparator

Standard surgery

Group Type ACTIVE_COMPARATOR

Standard surgery

Intervention Type PROCEDURE

Standard surgery without HIPEC CO2

Interventions

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Surgery plus HIPEC CO2

Prophylactic surgery plus HIPEC CO2 performed with mitomycin and cisplatin v

Intervention Type PROCEDURE

Standard surgery

Standard surgery without HIPEC CO2

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Patients with histologically documented gastric carcinoma (diffuse/intestinal histotype) eligibile for R0.

1. Presurgical or intraoperative stage T3-T4 N0-N+ primary tumour (TNM 8 th).
2. Urgent presentation: perforation without purulent generalized peritonitis
3. Positive cytology of peritoneal fluid (if previously obtained)
2. Age ≥ 18 years and ≤75 years.
3. Written informed consent.

Exclusion Criteria

1. Gastroesophageal Junction (GEJ) cancer
2. Distant metastatic disease (even if limited and completely resected)
3. Peritoneal carcinomatosis
4. History of tumor diagnosed in the 3 years before entering the study, except for topical and healed pathologies that do not need further treatment (e.g. non-melanoma skin carcinomas, superficial bladder carcinomas or in situ carcinoma of the breast or cervix).
5. Psychological, family or social conditions which may negatively affect the treatment and follow-up protocol.
6. Poor general conditions (ECOG \> 2).
7. Impaired cardiac function (history of congestive heart failure or FE \<40%). Clinically significant cardiovascular disease: cerebral vascular accident/stroke (\< 6 months prior to enrolment), unstable angina, congestive heart failure (New York Heart Association Classification Class \> II) or serious uncontrolled cardiac Arrhythmia requiring medication
8. Impaired renal function (creatinine\> 1.5 upper limit of normal or creatinine clearance \<60 mL / min).
9. Impaired hepatic function (AST, ALT \>2.5 upper limit of normal, bilirubin \> 1.5 upper limit of normal).
10. Impaired hematopoietic function (leucocytes \<4000 / mm3, neutrophils \<1500 / mm 3, platelets \<100000 / mm3).
11. Impaired pulmonary function (presence of COPD or other pulmonary restrictive conditions with FEV1 \<50% or DLCO \<40% of normal age value).
12. History or presence of other disease, metabolic dysfunction, or clinical laboratory finding giving reasonable suspicion of a disease or condition that contraindicates use of HIPEC or chemotherapy or patient at high risk from treatment complications.
13. Pregnancy.
14. Krukenberg tumor
15. Refusal to join the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Mario Negri Institute for Pharmacological Research

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Andrea Di Giorgio

Role: PRINCIPAL_INVESTIGATOR

Fondazione Policlinico Universitario Agostino Gemelli IRCCS

Locations

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IRCCS Istituto Tumori Giovanni Paolo II

Bari, , Italy

Site Status ACTIVE_NOT_RECRUITING

AO Santa Croce e Carle

Cuneo, , Italy

Site Status ACTIVE_NOT_RECRUITING

ULLS1 1 Dolomiti - Ospedale di Feltre

Feltre, , Italy

Site Status ACTIVE_NOT_RECRUITING

Policlinico di Milano

Milan, , Italy

Site Status ACTIVE_NOT_RECRUITING

A.O.R.N. A.Cardarelli

Napoli, , Italy

Site Status ACTIVE_NOT_RECRUITING

Azienda Ospedaliera Universitaria Federico II

Napoli, , Italy

Site Status ACTIVE_NOT_RECRUITING

Ospedale Evangelico Betania

Napoli, , Italy

Site Status ACTIVE_NOT_RECRUITING

Azienda Ospedaliera S. Camillo Forlanini

Roma, , Italy

Site Status ACTIVE_NOT_RECRUITING

Fondazione Policlinico Universitario A. Gemelli

Roma, , Italy

Site Status ACTIVE_NOT_RECRUITING

Fondazione Policlinico Universitario A. Gemelli

Roma, , Italy

Site Status RECRUITING

Fondazione Policlinico Universitario Agostino Gemelli Irccs Universita' Cattolica Del Sacro Cuore

Roma, , Italy

Site Status RECRUITING

IRCCS Policlinico San Donato

San Donato Milanese, , Italy

Site Status ACTIVE_NOT_RECRUITING

IRCCS Casa Sollievo della Sofferenza

San Giovanni Rotondo, , Italy

Site Status ACTIVE_NOT_RECRUITING

Countries

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Italy

Central Contacts

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Andrea Di Giorgio, MD

Role: CONTACT

003906 3015 ext. 7255

Erica Rulli

Role: CONTACT

0039023901 ext. 4684

Facility Contacts

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Alberto Biondi

Role: primary

Andrea Di Giorgio, MD

Role: primary

References

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Di Giorgio A, Gerardi C, Abatini C, Melotti G, Bonavina L, Torri V, Santullo F, Garattini S, De Luca M, Rulli E, Rulli E, Pacelli F; GOETH Investigators. Prophylactic surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC CO2) versus standard surgery for gastric carcinoma at high risk of peritoneal carcinomatosis: short and long-term outcomes (GOETH STUDY)-a collaborative randomized controlled trial by ACOI, FONDAZIONE AIOM, SIC, SICE, and SICO. Trials. 2022 Dec 1;23(1):969. doi: 10.1186/s13063-022-06880-y.

Reference Type DERIVED
PMID: 36457115 (View on PubMed)

Other Identifiers

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2019-001478-27

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

IRFMN-GCC-7813

Identifier Type: -

Identifier Source: org_study_id

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