NCT01585727

Brief Summary

One of the major problems of rectal cancer surgery is pelvic autonomic nerve damage, which is the main cause of urogenital dysfunction influencing postoperative quality of life. Costs for diagnostics and treatment of short and long-term urogenital dysfunction are immense. Varying degrees of urogenital dysfunction are found in up to 32% and 55% of patients with rectal cancer despite potentially nerve-sparing total mesorectal excision (TME). The study will examine the impact of a newly developed continuous monitoring device for preservation of urogenital function in patients with TME for rectal cancer. 188 patients will be included in the prospective, randomized, single-blind, parallel group multi-centre trial including two arms (TME with and without intraoperative continuous monitoring of pelvic autonomic nerves). The primary efficacy endpoint is the change in urinary function measured by International Prostate Function Score (IPSS) 12 months after surgery. Genital functions measured as secondary endpoints. The application of the continuous intraoperative neuromonitoring device could enhance the objective intraoperative confirmation of pelvic nerve sparing surgery. The investigators hypothesis is that the use of his device minimizes the risk of postoperative urogenital dysfunction in patients with TME for rectal cancer. An enormous reduction of treatment costs is to be expected.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
188

participants targeted

Target at P75+ for not_applicable

Timeline
Completed

Started Jun 2012

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

April 25, 2012

Completed
1 day until next milestone

First Posted

Study publicly available on registry

April 26, 2012

Completed
1 month until next milestone

Study Start

First participant enrolled

June 1, 2012

Completed
6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2018

Completed
6 months until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2018

Completed
Last Updated

February 27, 2019

Status Verified

February 1, 2019

Enrollment Period

6 years

First QC Date

April 25, 2012

Last Update Submit

February 26, 2019

Conditions

Keywords

Rectal cancertotal mesorectal excisionpelvic autonomic nerve preservationneurostimulationurogenital functionquality of life

Outcome Measures

Primary Outcomes (1)

  • Urogenital function

    Increase of IPSS score by at least 5 points observed 12 months after surgery compared to the preoperative IPSS score per patient

    12 months

Secondary Outcomes (6)

  • Sexual function (females)

    12 months

  • Sexual function (males)

    12 months

  • Adverse events

    12 months

  • Oncological safety

    12 months

  • Quality of mesorectal excision

    1 day after the surgery

  • +1 more secondary outcomes

Study Arms (2)

TME with neuromonitoring

EXPERIMENTAL

Total mesorectal excision with intraoperative neuromonitoring of pelvic autonomic nerves.

Procedure: TMEProcedure: Neuromonitoring

TME without neuromontoring

ACTIVE COMPARATOR

Total mesorectal excision without intraoperative neuromonitoring of pelvic autonomic nerves.

Procedure: TME

Interventions

TMEPROCEDURE

Total mesorectal excision

TME with neuromonitoring

Intraoperative neuromonitoring of pelvic autonomic nerves.

TME with neuromonitoring

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • informed consent
  • histologically confirmed carcinoma of the rectum (≤ 16 cm from anal verge)
  • fit for radical surgery
  • total mesorectal excision
  • age 18-80 years

You may not qualify if:

  • history of operation of the urinary tract (e.g. prostatectomy)
  • pacemaker
  • emergency operation
  • multivisceral resection in the pelvis
  • partial mesorectal excision
  • eligibility for local excision (TEM, intestinal wall resection)
  • ongoing infection or sepsis
  • severe untreated physical or mental impairment
  • pregnancy or breastfeeding
  • women of childbearing potential who are not using a highly effective birth control method
  • missing preoperative data on urogenital or anorectal function
  • simultaneous participation in another clinical trial
  • previous participation in this clinical trial
  • lack of cooperation with the trial procedure

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Department of General and Visceral Surgery, University Medical Center Mainz

Mainz, Germany

Location

Related Publications (1)

  • Kauff DW, Kronfeld K, Gorbulev S, Wachtlin D, Lang H, Kneist W. Continuous intraoperative monitoring of pelvic autonomic nerves during TME to prevent urogenital and anorectal dysfunction in rectal cancer patients (NEUROS): a randomized controlled trial. BMC Cancer. 2016 May 21;16:323. doi: 10.1186/s12885-016-2348-4.

MeSH Terms

Conditions

Rectal Neoplasms

Condition Hierarchy (Ancestors)

Colorectal NeoplasmsIntestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesIntestinal DiseasesRectal Diseases

Study Officials

  • Werner Kneist, Univ.-Prof.

    Department of Visceral and Abdominal Surgery, University Medical Center Mainz

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
PARTICIPANT
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Senior physician, Department of Visceral and Abdominal Surgery

Study Record Dates

First Submitted

April 25, 2012

First Posted

April 26, 2012

Study Start

June 1, 2012

Primary Completion

June 1, 2018

Study Completion

December 1, 2018

Last Updated

February 27, 2019

Record last verified: 2019-02

Locations