Conventional Partial Pancreatoduodenectomy Versus an Extended Pancreatoduodenectomy for Pancreatic Head Cancers

NCT ID: NCT06703905

Last Updated: 2024-11-25

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: NA
• Total Enrollment: 270 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2024-12-31
• Study Completion Date: 2028-12-31

Brief Summary

The goal of this clinical trial is to learn if traditional pancreaticoduodenectomy (PD) combined with TRIANGLE (extended PD surgery) can increase disease-free survival (DFS) in patients with pancreatic head cancers compared to traditional minimally invasive PD. The main questions it aims to answer are:

• Does extended PD surgery increase disease-free survival (DFS)?
• Does extended PD surgery could improve postoperative and long-term quality of life for patients? Researchers will compare extended PD surgery to traditional PD surgery to see if extended PD surgery could extend the survival time of patients.

Participants will:

• Accept traditional minimally invasive PD surgery or minimally invasive PD combined with TRIANGLE surgery.
• Visit the clinic once every 3 months for checkups and tests.
• Keep a diary of their symptoms.

Detailed Description

Pancreaticoduodenectomy (PD) currently stands as the sole option for treating resectable pancreatic head cancer; however, the long-term post-operative survival quality of patients remains unpromising. According to statistics from international multicenter studies, the 5-year survival rate of patients post-surgery does not exceed 20%. The principal causes for the suboptimal survival quality are the high recurrence and metastasis tendencies of pancreatic cancer, along with its low sensitivity and poor response to the existing neoadjuvant therapy. In contrast to traditional PD, PD combined with the TRIANGLE procedure (expanded PD) enables more thorough resection, effectively addressing the early recurrence and metastasis issues of pancreatic cancer and holds significant potential in enhancing patients' long-term survival quality. Nevertheless, there exists no high-level clinical evidence regarding the improvement of short-term complications for this surgical approach. Simultaneously, minimally invasive pancreatic surgeries have been demonstrated in high-throughput pancreatic centers to improve patients' short-term quality of life, yet the effect on long-term prognosis remains ambiguous. Hence, our center innovatively proposes minimally invasive PD in combination with the TRIANGLE procedure for the treatment of resectable pancreatic cancer, with the aim of integrating the advantages of both intervention measures to improve patients' post-operative quality of life and long-term survival quality.

This research will carry out a randomized controlled trial on patients with resectable pancreatic cancer who are scheduled to undergo minimally invasive PD in six Chinese centers and two foreign centers, comparing the prognostic disparities between traditional PD and the expanded PD procedure. The primary outcome measure is the postoperative disease-free survival (DFS), defined as "the time from randomization to disease recurrence or death for any reason." The projected enrollment period is 15 months, and the follow-up duration is 3 years.

Conditions

Pancreatic Cancer Resectable

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

PD group

Traditional minimally invasive pancreaticoduodenectomy

Group Type: ACTIVE_COMPARATOR

Pancreaticoduodenectomy

Intervention Type: PROCEDURE

Traditional minimally invasive pancreaticoduodenectomy

expanded PD group

Traditional minimally invasive pancreaticoduodenectomy combined with the TRIANGLE procedure

Group Type: EXPERIMENTAL

Expanded pancreaticoduodenectomy surgery

Intervention Type: PROCEDURE

Traditional minimally invasive pancreaticoduodenectomy combined with the TRIANGLE procedure

Interventions

Expanded pancreaticoduodenectomy surgery

Traditional minimally invasive pancreaticoduodenectomy combined with the TRIANGLE procedure

Intervention Type: PROCEDURE

Pancreaticoduodenectomy

Traditional minimally invasive pancreaticoduodenectomy

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

1. Preoperative: a. Patients with suspected or histologically verified resectable, borderline or locally advanced pancreatic cancer of the pancreatic head (i.e. pancreatic ductal adenocarcinoma, intraductal papillary mucinous neoplasm (IPMN)-carcinoma or periampullary cancer of the pancreatobiliary-type) ; b. Patients scheduled for elective partial pancreatoduodenectomy (irrespective of neoadjuvant therapy); c. Assumed resectability in accordance with the surgical protocol for experimental and control intervention as judged by the treating surgeon; d. Ability of the subject to understand character and individual consequences of the clinical trial;e.Written informed consent; f. Age ≥ 18 years;

2. Intraoperative: a.No distant metastases; b.No paraaortic lymph node metastases; c.Intraoperative confirmation that the patient can be operated on according to both surgical methods.

Exclusion Criteria

1. Participation in another interventional trial with the interference of intervention and outcome of this trial;

2. American Society of Anesthesiologists (ASA) grade >3;

3. Distant metastatic disease .

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 100 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

First Affiliated Hospital Xi'an Jiaotong University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Central Contacts

Zheng Wang, Doctor

Role: CONTACT

zheng.wang11@mail.xjtu.edu.cn

86+15902993665

Other Identifiers

ZXIIT2024180

Identifier Type: -

Identifier Source: org_study_id