Laparoscopic Surgery or Robotic-Assisted Laparoscopic Surgery in Treating Patients With Rectal Cancer That Can Be Removed By Surgery
Study Details
Study Description
Brief Summary
RATIONALE: Robotic-assisted laparoscopic surgery may be a less invasive type of surgery for rectal cancer and may have fewer side effects and improve recovery. It is not yet known whether robotic-assisted laparoscopic surgery is more effective than laparoscopic surgery in treating patients with rectal cancer.
PURPOSE: This randomized clinical trial studies robotic-assisted laparoscopic surgery to see how well it works compared to laparoscopic surgery in treating patients with rectal cancer that can be removed by surgery.
Condition or Disease | Intervention/Treatment | Phase |
---|---|---|
|
N/A |
Detailed Description
OBJECTIVES:
-
To evaluate robotic-assisted rectal cancer surgery versus standard laparoscopic rectal cancer resection by means of a randomized, controlled trial.
-
To assess technical ease of the operation, as determined by the clinical indicator of low conversion rate to open operation.
-
To assess surgical accuracy and improved oncological outcome as determined by clear pathological resection margins.
-
To assess quality of life and analyze cost-effectiveness to aid evidence-based knowledge to inform NHS and other service providers and decision-makers.
-
To analyze disease-free and overall survival and local recurrence rates at 3-year follow-up.
OUTLINE:
Patients are randomized to 1 of 2 treatment arms.
ARM I: Patients undergo standard laparoscopic resection.
ARM II: Patients undergo robotic-assisted laparoscopic resection.
After completion of study treatment, patients are followed up at 1 month, 6 months, and then annually thereafter for 3 years.
Study Design
Arms and Interventions
Arm | Intervention/Treatment |
---|---|
Active Comparator: Arm I Patients undergo standard conventional laparoscopic resection. |
Procedure: conventional laparoscopic surgery
operation using conventional laparoscopic techniques
Other Names:
Procedure: quality-of-life assessment
Ancillary studies
Other Names:
Other: questionnaire administration
Ancillary studies
|
Experimental: Arm II Patients undergo robotic-assisted laparoscopic resection. |
Procedure: robotic-assisted laparoscopic surgery
operation that involves use of laparoscopic assistance with robotic assistance
Procedure: quality-of-life assessment
Ancillary studies
Other Names:
Other: questionnaire administration
Ancillary studies
|
Outcome Measures
Primary Outcome Measures
- Rate of conversion to open surgery as an indicator of surgical technical difficulty [At completion of surgery]
Secondary Outcome Measures
- Circumferential resection margin positivity rate [At completion of pathology review]
- Local recurrence rate [At 3 years]
- Intra-operative and post-operative complications [At day 30 and 6 months]
- Operative mortality [At day 30]
- Self reported bladder and sexual function [At day 30 and 6 months]
- Health related quality of life [At day 30 and 6 months]
- Disease free and overall survival [At 3 years]
- Intra-operative laparoscopic skills (randomly selected cases only) as assessed by the global assessment tool for evaluation of intra-operative laparoscopic skills (GOALS) [Upon completion of GOALS assessment by an independent expert]
- Quality of the plane of surgery as assessed by central review of photographs [At completion of the central review of photographs]
- Health economics [At day 30 and 6 months]
Eligibility Criteria
Criteria
Inclusion
-
Able to provide written informed consent
-
Diagnosis of rectal cancer amenable to curative surgery either by anterior resection or abdominoperineal resection (i.e. staged T1-3, N0-2, M0 by CT and MRI or transrectal ultrasound)
-
Rectal cancer suitable for resection by either standard or robotic-assisted laparoscopic procedure
-
Fit for robotic-assisted or standard laparoscopic rectal resection
-
ASA =< 3
-
Capable of completing required questionnaires at time of consent
Exclusion
-
Benign lesions of the rectum
-
Cancers of the anal canal
-
Locally advanced cancers not amenable to curative surgery
-
Locally advanced cancers requiring en bloc multi-visceral resection
-
Synchronous colorectal tumours requiring multi-segment surgical resection
-
Co-existent inflammatory bowel disease
-
Clinical or radiological evidence of metastatic spread
-
Concurrent or previous diagnosis of invasive cancer within 5 years that could confuse diagnosis (non-melanomatous skin cancer or superficial bladder cancer treated with curative intent are acceptable; for other cases please discuss with Chief Investigator via CTRU)
-
History of psychiatric or addictive disorder or other medical condition that, in the opinion of the investigator, would preclude the patient from meeting the trial requirements
-
Pregnancy
-
Participation in another rectal cancer clinical trial relating to surgical technique
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- City of Hope Medical Center
Investigators
- Principal Investigator: Alessio Pigazzi, City of Hope Medical Center
Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- 07158
- NCI-2010-01427