Regional or Extend LymphAdenectomy During Resection of Intrahepatic Cholangiocarcinoma

NCT ID: NCT04078230

Last Updated: 2022-11-09

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

RECRUITING

Clinical Phase

NA

Total Enrollment

168 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-01

Study Completion Date

2027-12-31

Brief Summary

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Intrahepatic cholangiocarcinoma (ICC) is one of the common malignant tumors. Lymph node metastasis is an important factor affecting the poor prognosis of intrahepatic cholangiocarcinoma. The eighth edition of the AJCC guidelines recommends at least 6 lymph nodes to be used for staging. The American Hepatobiliary and Pancreatic Association also recommends the removal of hilar lymph nodes as part of the radical surgery for intrahepatic cholangiocarcinoma. However, some scholars have found that patients with regional lymph nodes have similar survival rates. This contradictory result has prompted more scholars to conduct clinical research to explore the necessity and standardization of lymph node dissection in intrahepatic cholangiocarcinoma.

Detailed Description

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Expanding lymph node dissection can theoretically obtain more lymph node dissection. Obtaining enough lymph nodes can improve the accuracy of AJCC staging and accurately determine prognosis. However, it is unclear whether it will improve the prognosis of patients with lymph node dissection. According to literature reports and related studies, expanded lymph node dissection for right liver tumors included stations 12, 8, and 13, and left lymphoma expanded lymph node dissection includedstations 12, 1, 3, 7, and 8.

In summary, standardize the extent of lymph node dissection in intrahepatic cholangiocarcinoma, and obtain enough lymph node dissection under the premise of controlling the complication rate, which is helpful for accurate TNM staging, accurate judgment of prognosis and improvement of survival time. Improve prognosis.

Conditions

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Intrahepatic Cholangiocarcinoma

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

resectable intrahepatic cholangiocarcinoma
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Participants

Study Groups

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Extend LymphAdenectomy

Expanded lymph node dissection for right liver tumors included stations 12, 8, and 13, and stations 12, 1, 3, 7, and 8 for left liver tumors

Group Type EXPERIMENTAL

Extend LymphAdenectomy

Intervention Type PROCEDURE

Expanded lymph node dissection for right liver tumors included stations 12, 8, and 13, and stations 12, 1, 3, 7, and 8 for left liver tumors

Regional LymphAdenectomy

Regional lymph node dissection for intrahepatic cholangiocarcinoma included station 12.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Extend LymphAdenectomy

Expanded lymph node dissection for right liver tumors included stations 12, 8, and 13, and stations 12, 1, 3, 7, and 8 for left liver tumors

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Patients \>18 years of age and ≤80 years of age;
* Preoperative imaging and laboratory examination for intrahepatic cholangiocarcinoma, intraoperative frozen and postoperative pathology confirmed as intrahepatic cholangiocarcinoma; preoperative imaging assessment is resectable;
* No obvious lymph node metastasis in preoperative imaging; or negative intraoperative lymph node biopsy
* Liver function Child-Turcotte-Pugh score A-B grade;
* Residual liver volume \>30%; can tolerate radical hepatectomy
* The patient has autonomy, understands and voluntarily signs the written informed consent and is able to complete the follow-up plan;
* Sign the written informed consent form prior to the test screening.

Exclusion Criteria

* The patient has obvious heart, lung, brain and kidney dysfunction that affects the treatment of intrahepatic cholangiocarcinoma;
* The patient has a history of other malignant tumors;
* Liver function Child-Turcotte-Pugh score C;
* The investigator determined that it was not suitable for the study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Second Affiliated Hospital, School of Medicine, Zhejiang University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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The Johns Hopkins Hospital

Baltimore, Maryland, United States

Site Status RECRUITING

China-Japan Friendship Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

Chinese PLA General Hospital

Beijing, Beijing Municipality, China

Site Status RECRUITING

Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University

Guangzhou, Guangdong, China

Site Status RECRUITING

Hunan Provincial People's Hospital

Changsha, Hunan, China

Site Status RECRUITING

The Affiliated Hospital of Inner Mongolia Medical University

Hohhot, Inner Mongolia, China

Site Status RECRUITING

Renji Hospital Affiliated to Shanghai Jiao Tong University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Xinhua Hospital Affiliated to Shanghai Jiao Tong University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

Zhong Shan Hospital Fudan University

Shanghai, Shanghai Municipality, China

Site Status RECRUITING

The First Affiliated Hospital of Xi 'an Jiaotong University

Xi’an, Shanxi, China

Site Status RECRUITING

West China Hospital Sichuan University

Chengdu, Sichuan, China

Site Status RECRUITING

The Second Affiliated Hospital Zhejiang University School of Medicine

Hanzhou, Zhejiang, China

Site Status RECRUITING

Zhejiang cancer hospital

Hanzhou, Zhejiang, China

Site Status RECRUITING

Countries

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United States China

Central Contacts

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Jiang-Tao LI, PHD;MD

Role: CONTACT

86-15906686716

Facility Contacts

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Jin He, MD

Role: primary

Zhiying Yang, MD

Role: primary

Zhiming Zhao, MD

Role: primary

Chao Liu, MD

Role: primary

Xianhai Mao, MD

Role: primary

Zhengxia Wang, MD

Role: primary

Jian Wang, MD

Role: primary

Wei Gong, MD

Role: primary

Houbao Liu, MD

Role: primary

Zhimin Geng, MD

Role: primary

Fuyu Li, MD

Role: primary

Jiang-tao Li, MD

Role: primary

86-13666651245

Xinbao Wang, MD

Role: primary

References

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Njei B. Changing pattern of epidemiology in intrahepatic cholangiocarcinoma. Hepatology. 2014 Sep;60(3):1107-8. doi: 10.1002/hep.26958. Epub 2014 Jul 28. No abstract available.

Reference Type RESULT
PMID: 24327308 (View on PubMed)

Zhang XF, Chakedis J, Bagante F, Chen Q, Beal EW, Lv Y, Weiss M, Popescu I, Marques HP, Aldrighetti L, Maithel SK, Pulitano C, Bauer TW, Shen F, Poultsides GA, Soubrane O, Martel G, Groot Koerkamp B, Guglielmi A, Itaru E, Pawlik TM. Trends in use of lymphadenectomy in surgery with curative intent for intrahepatic cholangiocarcinoma. Br J Surg. 2018 Jun;105(7):857-866. doi: 10.1002/bjs.10827. Epub 2018 Apr 14.

Reference Type RESULT
PMID: 29656380 (View on PubMed)

Weber SM, Ribero D, O'Reilly EM, Kokudo N, Miyazaki M, Pawlik TM. Intrahepatic cholangiocarcinoma: expert consensus statement. HPB (Oxford). 2015 Aug;17(8):669-80. doi: 10.1111/hpb.12441.

Reference Type RESULT
PMID: 26172134 (View on PubMed)

Kim DH, Choi DW, Choi SH, Heo JS, Kow AW. Is there a role for systematic hepatic pedicle lymphadenectomy in intrahepatic cholangiocarcinoma? A review of 17 years of experience in a tertiary institution. Surgery. 2015 Apr;157(4):666-75. doi: 10.1016/j.surg.2014.11.006. Epub 2015 Feb 12.

Reference Type RESULT
PMID: 25682172 (View on PubMed)

Shimada M, Yamashita Y, Aishima S, Shirabe K, Takenaka K, Sugimachi K. Value of lymph node dissection during resection of intrahepatic cholangiocarcinoma. Br J Surg. 2001 Nov;88(11):1463-6. doi: 10.1046/j.0007-1323.2001.01879.x.

Reference Type RESULT
PMID: 11683741 (View on PubMed)

Lendoire JC, Gil L, Imventarza O. Intrahepatic cholangiocarcinoma surgery: the impact of lymphadenectomy. Chin Clin Oncol. 2018 Oct;7(5):53. doi: 10.21037/cco.2018.07.02. Epub 2018 Jul 17.

Reference Type RESULT
PMID: 30180752 (View on PubMed)

Ribero D, Pinna AD, Guglielmi A, Ponti A, Nuzzo G, Giulini SM, Aldrighetti L, Calise F, Gerunda GE, Tomatis M, Amisano M, Berloco P, Torzilli G, Capussotti L; Italian Intrahepatic Cholangiocarcinoma Study Group. Surgical Approach for Long-term Survival of Patients With Intrahepatic Cholangiocarcinoma: A Multi-institutional Analysis of 434 Patients. Arch Surg. 2012 Dec;147(12):1107-13. doi: 10.1001/archsurg.2012.1962.

Reference Type RESULT
PMID: 22910846 (View on PubMed)

Doussot A, Lim C, Gomez-Gavara C, Fuks D, Farges O, Regimbeau JM, Azoulay D; AFC-IHCC Study Group. Multicentre study of the impact of morbidity on long-term survival following hepatectomy for intrahepatic cholangiocarcinoma. Br J Surg. 2016 Dec;103(13):1887-1894. doi: 10.1002/bjs.10296. Epub 2016 Sep 15.

Reference Type RESULT
PMID: 27629502 (View on PubMed)

Other Identifiers

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IHCC-china

Identifier Type: -

Identifier Source: org_study_id

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