Organ-preserving Management in Patients With Complete or Near-complete Tumour Response After Preoperative Radio(Chemo)Therapy for Rectal Cancer

NCT ID: NCT04095468

Last Updated: 2019-09-19

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

Total Enrollment

215 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-09-18

Study Completion Date

2026-01-01

Brief Summary

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Watch-and-wait strategy in rectal cancer is gaining momentum. There is a large variability in reporting the proportion of patients achieving clinical complete response (cCR) after routinely delivered preoperative radio(chemo)therapy, likely because of patients' selection. This proportion in population-based level is poorly defined. In addition, predictive factors for cCR are also poorly defined. It is known that cCR response is observed often in small tumours. However, cCR proportion in large cancers has not been sufficiently evaluated. For example, even though pathological complete response (pCR) does occur in large fixed cancer, it is unknown whether cCR does also occur because persistent fibrous stroma may mimic residual cancer in all of such cases.

This is a prospective observational population-based cohort study on low rectal cancer to answer the question of how often clinical or near-clinical tumour response occur after routinely delivered preoperative radiotherapy in relation to the pre-treatment tumour characteristics. The additional question was how often pCR occur in relation to the pre-treatment tumour characteristics in the patients managed by total mesorectal excision because of persistent tumour after radiotherapy. The additional aim was the implementation of watch-and-wait strategy or full-thickness local excision (as an option instead of total mesorectal excision in the patients with sustained near-cCR) within a frame of a prospective study. In the patients managed by organ preservation, the secondary outcome measures were: i) local regrowth rate, ii) effectiveness of salvage surgery, iii) disease-free survival at 3 years and overall survival at 5 years, iv) anorectal function.

Detailed Description

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Conditions

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Rectal Neoplasms Rectal Cancer

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Resectable rectal cancer

Preoperative Radio(Chemo)Therapy

Intervention Type RADIATION

Preoperative radiotherapy +/- chemotherapy, then surgery (total mesorectal excision) or watch-and-wait

Rectal cancer with threatened mesorectal fascia

Preoperative Radio(Chemo)Therapy

Intervention Type RADIATION

Preoperative radiotherapy +/- chemotherapy, then surgery (total mesorectal excision) or watch-and-wait

Interventions

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Preoperative Radio(Chemo)Therapy

Preoperative radiotherapy +/- chemotherapy, then surgery (total mesorectal excision) or watch-and-wait

Intervention Type RADIATION

Eligibility Criteria

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Inclusion Criteria

* Primary rectal cancer
* Low tumour (accessible by digital rectal examination)
* Routine preoperative radio(chemo)therapy according to the institutional policy; short-course radiation and immediate surgery is not allowed.
* Informed consent for watch-and-wait strategy or local excision in patients with cCR and near-cCR

Exclusion Criteria

* Recurrent cancer
* Cancers situated in the upper rectum
* Distant metastases
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Polish Society of Surgical Oncology

UNKNOWN

Sponsor Role collaborator

Maria Sklodowska-Curie National Research Institute of Oncology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Maria Skłodowska-Curie Institute - Oncology Center

Warsaw, Mazovian, Poland

Site Status RECRUITING

Collegium Medicum Nicolaus Copernicus University and Oncology Centre

Bydgoszcz, , Poland

Site Status RECRUITING

Regional Oncological Centre

Kielce, , Poland

Site Status RECRUITING

Jagiellonian Medical University College

Krakow, , Poland

Site Status NOT_YET_RECRUITING

St. John's Cancer Center

Lublin, , Poland

Site Status RECRUITING

Silesian Oncological Centre

Wroclaw, , Poland

Site Status RECRUITING

NU-MED Centre for Cancer Diagnosis and Treatment

Zamość, , Poland

Site Status RECRUITING

Countries

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Poland

Central Contacts

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Krzysztof Bujko, M.D. PhD

Role: CONTACT

+48601207466

Facility Contacts

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Krzysztof Bujko, M.D. PhD

Role: primary

+48601207466

Michał Jankowski, M.D.

Role: primary

Jacek Sadowski, M.D.

Role: primary

Piotr Richter, M.D.

Role: primary

Małgorzata Jankiewicz, M.D.

Role: primary

Jolanta Szelachowska, M.D.

Role: primary

Marek Mazurek, M.D.

Role: primary

Other Identifiers

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ORGANPRESERV1

Identifier Type: -

Identifier Source: org_study_id

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