EMR Versus ESD for Barrett's Neoplasia

NCT ID: NCT05276791

Last Updated: 2022-07-21

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

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

331 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-12-01

Study Completion Date

2026-12-01

Brief Summary

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Rationale:

The optimal technique for removal of visible dysplastic lesions in Barrett's esophagus remains controversial. Endoscopic mucosal resection (EMR) is safe, effective, easy to apply, and has been the most widely used technique since 2008. Endoscopic submucosal dissection (ESD) is a more controlled dissection method with potential improved efficacy, but at the cost of higher technical complexity.

Objective:

The investigators aim to compare EMR and ESD for removal of visible lesions in Barrett's esophagus.

Study design:

Randomized clinical trial

Study population:

Patients with Barrett's esophagus and a visible lesion with dysplasia and/or early cancer. Suspicion for submucosal invasion is an exclusion criterion.

Intervention:

Patients are randomized to receive either EMR or ESD, with follow-up and no ablation during 12 months after the resection.

Main study endpoint:

Primary endpoint is the proportion of patients with no evidence of residual or local recurrent neoplasia during 12 months follow-up after baseline.

Detailed Description

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Conditions

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Barretts Esophagus With Dysplasia Barrett Adenocarcinoma Esophageal Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized study
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Endoscopic submucosal dissection

Group Type ACTIVE_COMPARATOR

ESD

Intervention Type OTHER

Endoscopic submucosal dissection, according to standard care

Endoscopic mucosal resection

Group Type ACTIVE_COMPARATOR

EMR

Intervention Type OTHER

Endoscopic mucosal resection, according to standard care

Interventions

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EMR

Endoscopic mucosal resection, according to standard care

Intervention Type OTHER

ESD

Endoscopic submucosal dissection, according to standard care

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients age: ≥ 18 years
* Willingness to undergo both EMR or ESD
* Ability to provide written, informed consent (approved by IRB) and understand the responsibilities of trial participation
* BE with a single visible lesion with absence of signs of submucosal invasion on endoscopy, after evaluation by the adjudication committee.

Exclusion Criteria

* Patients with visible lesions with suspicion of submucosal invasion bases on assessment of the adjudication committee
* History of esophageal surgery other than fundoplication
* History of esophageal ablation therapy or endoscopic resection
* Multiple visible lesions in the BE segment at baseline
* Uncontrolled coagulopathy with INR \>2.0, thrombocytopenia with platelet counts \< 50,000
* Subject has a known history of unresolved drug or alcohol dependency that would limit ability to comprehend or follow instructions related to informed consent, post-treatment in-structions, or follow-up guidelines
* Life expectancy \<2 years
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Medical Center Groningen

OTHER

Sponsor Role collaborator

Amsterdam UMC, location VUmc

OTHER

Sponsor Role collaborator

Erasmus Medical Center

OTHER

Sponsor Role collaborator

UMC Utrecht

OTHER

Sponsor Role collaborator

Catharina Ziekenhuis Eindhoven

OTHER

Sponsor Role collaborator

St. Antonius Hospital

OTHER

Sponsor Role collaborator

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

OTHER

Sponsor Role lead

Responsible Party

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Sanne van Munster

Principal Investigator (Bas Weusten)

Responsibility Role PRINCIPAL_INVESTIGATOR

Other Identifiers

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001

Identifier Type: -

Identifier Source: org_study_id

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