A Phase III Study of En Bloc Versus Non-En Bloc Esophagectomy in Esophageal Cancer

NCT00760604 | Terminated Phase 3

• 1 other identifier: 0806009855
• Study Type: interventional
• Target: 4
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to test 2 different methods of surgery to remove cancer in the esophagus. This research is being done to see whether removing more tissue and lymph nodes surrounding the tumor in the esophagus (known as transthoracic en bloc esophagectomy) offers better control of the cancer than removing less tissue and lymph nodes (known as non-en bloc esophagectomy).

Conditions

Esophageal Neoplasms

Keywords

Esophageal neoplasms; Esophagectomy

Outcome Measures

Primary Outcomes (1)

• Disease free survival defined as the time from surgical resection to the time of recurrent disease, death from esophageal cancer, or death from any cause.

  CT scans will be performed every 6 months for 5 years.

Secondary Outcomes (4)

• To determine 5-year overall and disease-specific survival in arm A and arm B

  CT scans every 6 months for 5 years

• To determine the rates of local and systemic recurrence in arm A vs. arm B

  CT scans performed every 6 months for 5 years

• To determine time to progression in arm A vs. arm B

  CT scans every 6 months for 5 years

• To determine mortality and morbidity in arm A vs. arm B

  5 years from the date of surgical resection

Study Arms (2)

A

ACTIVE COMPARATOR

En bloc esophagectomy is performed through a transthoracic approach by removing the tumor-bearing esophagus, the pericardium anteriorly, both pleural surfaces laterally, as well as the thoracic duct and all other lymphoareolar tissue wedged posteriorly between the esophagus and the spine, and en-bloc resection of all nodal groups in the middle and lower mediastinum as well as the upper abdomen.

Procedure: Esophagectomy

B

ACTIVE COMPARATOR

Transhiatal esophagectomy is performed through an abdominal incision and a neck incision. The stomach is mobilized, and the left gastric vessels are transected at its origin. Celiac lymph nodes are dissected, and the intrathoracic esophagus is dissected bluntly through the hiatus and through the neck. The cervical esophagus is divided at the level of the neck. After the esophagogastrectomy is performed, a gastric tube is created. An esophagogastrostomy is then performed in the neck. If a transthoracic approach is used, dissection will be as described for the transhiatal approach.

Procedure: Esophagectomy

Interventions

Esophagectomy PROCEDURE

Comparison of en-bloc vs. non-en bloc esophagectomy

A; B

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients with cT2-T3/N0-N1-M1a-M1b(lymph node metastasis only) esophageal squamous cell and adenocarcinoma who have potentially resectable disease.
• Karnofsky performance status greater than or equal to 80%.
• Pulmonary and cardiac function must be acceptable for surgery according to institutional standards.
• Acceptable hepatic, renal and bone marrow function.
• Age 18 or older.
• Patients may receive preoperative chemotherapy and/or radiation therapy as part of their clinical care.

You may not qualify if:

• Patients with clearly unresectable or metastatic esophageal cancer or clinical stage I esophageal cancer.
• Significant psychiatric illness that would interfere with patient compliance.
• Patients with any other serious underlying medical condition that would impair the ability of the patient to receive or comply with protocol treatment.
• Patients with a significant history of unstable cardiovascular disease (e.g., inadequately controlled hypertension, or angina; myocardial infarction within the previous 6 months; ventricular cardiac arrhythmias requiring medication; congestive heart failure that in the opinion of the treating physician should preclude the patient from protocol treatment.
• Uncontrolled diabetes mellitus or uncontrolled infection, including HIV or interstitial pneumonia or interstitial fibrosis.

Sponsors & Collaborators

• Weill Medical College of Cornell University: lead

Study Sites (1)

Weill Medical College of Cornell Unversity

New York, New York, 10065, United States

Location

MeSH Terms

Conditions

Esophageal Neoplasms

Interventions

Esophagectomy

Condition Hierarchy (Ancestors)

Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Head and Neck Neoplasms; Digestive System Diseases; Esophageal Diseases; Gastrointestinal Diseases

Intervention Hierarchy (Ancestors)

Digestive System Surgical Procedures; Surgical Procedures, Operative

Study Officials

• Paul C Lee, M.D.

  Weill Medical College of Cornell University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor of Cardiothoracic Surgery

Study Record Dates

• First Submitted: September 25, 2008
• First Posted: September 26, 2008
• Study Start: September 1, 2008
• Primary Completion: April 1, 2012
• Study Completion: April 1, 2012
• Last Updated: August 13, 2012

Record last verified: 2012-08

Locations

US (1)