NCT03193710

Brief Summary

The body immunity is important to the development of tumor. The immune system is in charge of monitoring and cleaning tumor cells in circulation. Anesthesia may alter the immune response and affect the elimination of tumor cells. The purpose of the trial is to test whether inhalational anesthetic is relevant to tumor metastasis and recurrence of patients undergoing colorectal cancer resection through depression of lymphocytes-mediated immunity.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
260

participants targeted

Target at P75+ for all trials

Timeline
Completed

Started Sep 2017

Longer than P75 for all trials

Geographic Reach
1 country

1 active site

Status
unknown

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

June 12, 2017

Completed
9 days until next milestone

First Posted

Study publicly available on registry

June 21, 2017

Completed
2 months until next milestone

Study Start

First participant enrolled

September 1, 2017

Completed
1.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 1, 2018

Completed
5 years until next milestone

Study Completion

Last participant's last visit for all outcomes

October 1, 2023

Completed
Last Updated

November 6, 2017

Status Verified

June 1, 2017

Enrollment Period

1.1 years

First QC Date

June 12, 2017

Last Update Submit

November 1, 2017

Conditions

Keywords

Intravenous anesthesiaInhalational anesthesiaColorectal cancer resectionLymphocytesMetastasisSurvivalMolecular mechanism

Outcome Measures

Primary Outcomes (2)

  • Change from baseline lymphocytes within postoperative 5 years

    Blood will be drawn preoperatively ( at least 24 hours before surgery), prior to anesthesia induction, immediately postoperatively, 24 hours postoperatively, and at postoperative appointments for testing CD4+/CD8+, B lymphocytes, dendritic cells, natural killer cells

    up to 5 years

  • Cancer free survival

    Patients who remain alive without known colonal or rectal tumor recurrence

    5 years or as available

Secondary Outcomes (9)

  • Cancer recurrence rate

    up to 5 years

  • Cancer metastasis rate

    up to 5 years

  • Re-operation

    up to 5 years

  • Anesthesia scheme for re-operation

    up to 5 years

  • Radiotherapy rate for any cancer

    up to 5 years

  • +4 more secondary outcomes

Other Outcomes (2)

  • Re-operation during hospitalization

    From end of colorectal cancer resection surgery to discharge, up to one month

  • Days of hospitalization

    From end of colorectal cancer resection surgery to discharge, up to one month

Study Arms (2)

Total intravenous anesthesia group

The anesthesia of patients in the total intravenous anesthesia group will be maintained with propofol and remifentanil.

Drug: PropofolDrug: Remifentanil

Inhalational anesthesia group

The anesthesia of patients in the inhalational anesthesia group will be maintained with sevoflurane and remifentanil.

Drug: SevofluraneDrug: Remifentanil

Interventions

Propofol will be used for anesthesia maintenance in the total intravenous anesthesia group.

Also known as: Diprivan
Total intravenous anesthesia group

Sevoflurane will be used for anesthesia maintenance in the inhalation anesthesia group.

Also known as: Abbvie
Inhalational anesthesia group

Remifentanil will be used for analgesia in both groups.

Also known as: YiChang HumanWell Pharmaceutical Co.,LTD. China
Inhalational anesthesia groupTotal intravenous anesthesia group

Eligibility Criteria

Age18 Years - 65 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)
Sampling MethodProbability Sample
Study Population

Patients with colonal or rectal cancer undergoing cancer resection with general anesthesia

You may qualify if:

  • All the patients diagnosed with colonal or rectal cancer
  • Aged 18-65
  • ASA I-III
  • Assigned to receive resection surgery under general anesthesia, with an expected duration of 2 hours or more
  • Agree to participate and give signed written informed consent.

You may not qualify if:

  • Severe organic heart, liver and kidney diseases
  • Diabetes or hemopoietic disorders
  • Allergy to general anesthetics
  • Family historical malignant hyperthermia
  • Cognition dysfunction
  • End-stage cancer or with over 2 cancer metastasis, pathological results were benign tumor or TNM stage was over T1- 3N0 - 2M0
  • Other primary malignant tumor
  • Immune deficiency or dysfunction or autoimmune disease or long-term usage of corticoids or immunosuppressants
  • Receiving general anesthesia within the last 3 months before the resection surgery
  • Perioperative transfusion

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

West China Hospital of Sichuan University, Department of Anesthesiology

Chengdu, Sichuan, 610041, China

RECRUITING

Related Publications (10)

  • Sofra M, Fei PC, Fabrizi L, Marcelli ME, Claroni C, Gallucci M, Ensoli F, Forastiere E. Immunomodulatory effects of total intravenous and balanced inhalation anesthesia in patients with bladder cancer undergoing elective radical cystectomy: preliminary results. J Exp Clin Cancer Res. 2013 Feb 3;32(1):6. doi: 10.1186/1756-9966-32-6.

    PMID: 23374147BACKGROUND
  • Qiao Y, Feng H, Zhao T, Yan H, Zhang H, Zhao X. Postoperative cognitive dysfunction after inhalational anesthesia in elderly patients undergoing major surgery: the influence of anesthetic technique, cerebral injury and systemic inflammation. BMC Anesthesiol. 2015 Oct 23;15:154. doi: 10.1186/s12871-015-0130-9.

    PMID: 26497059BACKGROUND
  • Moller Petrun A, Kamenik M. Bispectral index-guided induction of general anaesthesia in patients undergoing major abdominal surgery using propofol or etomidate: a double-blind, randomized, clinical trial. Br J Anaesth. 2013 Mar;110(3):388-96. doi: 10.1093/bja/aes416. Epub 2012 Nov 19.

    PMID: 23166149BACKGROUND
  • Jaura AI, Flood G, Gallagher HC, Buggy DJ. Differential effects of serum from patients administered distinct anaesthetic techniques on apoptosis in breast cancer cells in vitro: a pilot study. Br J Anaesth. 2014 Jul;113 Suppl 1:i63-7. doi: 10.1093/bja/aet581. Epub 2014 Jul 9.

    PMID: 25009197BACKGROUND
  • Buckley A, McQuaid S, Johnson P, Buggy DJ. Effect of anaesthetic technique on the natural killer cell anti-tumour activity of serum from women undergoing breast cancer surgery: a pilot study. Br J Anaesth. 2014 Jul;113 Suppl 1:i56-62. doi: 10.1093/bja/aeu200. Epub 2014 Jul 9.

    PMID: 25009196BACKGROUND
  • Wigmore TJ, Mohammed K, Jhanji S. Long-term Survival for Patients Undergoing Volatile versus IV Anesthesia for Cancer Surgery: A Retrospective Analysis. Anesthesiology. 2016 Jan;124(1):69-79. doi: 10.1097/ALN.0000000000000936.

    PMID: 26556730BACKGROUND
  • Woo JH, Baik HJ, Kim CH, Chung RK, Kim DY, Lee GY, Chun EH. Effect of Propofol and Desflurane on Immune Cell Populations in Breast Cancer Patients: A Randomized Trial. J Korean Med Sci. 2015 Oct;30(10):1503-8. doi: 10.3346/jkms.2015.30.10.1503. Epub 2015 Sep 12.

    PMID: 26425050BACKGROUND
  • Bayliss DA, Barrett PQ. Emerging roles for two-pore-domain potassium channels and their potential therapeutic impact. Trends Pharmacol Sci. 2008 Nov;29(11):566-75. doi: 10.1016/j.tips.2008.07.013. Epub 2008 Sep 25.

    PMID: 18823665BACKGROUND
  • Pei L, Tan G, Wang L, Guo W, Xiao B, Gao X, Wang L, Li H, Xu Z, Zhang X, Zhao J, Yi J, Huang Y. Comparison of combined general-epidural anesthesia with general anesthesia effects on survival and cancer recurrence: a meta-analysis of retrospective and prospective studies. PLoS One. 2014 Dec 30;9(12):e114667. doi: 10.1371/journal.pone.0114667. eCollection 2014.

    PMID: 25548913BACKGROUND
  • Shi C, Thum C, Zhang Q, Tu W, Pelaz B, Parak WJ, Zhang Y, Schneider M. Inhibition of the cancer-associated TASK 3 channels by magnetically induced thermal release of Tetrandrine from a polymeric drug carrier. J Control Release. 2016 Sep 10;237:50-60. doi: 10.1016/j.jconrel.2016.06.044. Epub 2016 Jul 1.

    PMID: 27374629BACKGROUND

Biospecimen

Retention: SAMPLES WITHOUT DNA

Blood of the enrolled patients will be sampled at different time-points for examination of lymphocytes.

MeSH Terms

Conditions

Neoplasm Metastasis

Interventions

PropofolSevofluraneRemifentanil

Condition Hierarchy (Ancestors)

Neoplastic ProcessesNeoplasmsPathologic ProcessesPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

PhenolsBenzene DerivativesHydrocarbons, AromaticHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsMethyl EthersEthersHydrocarbons, FluorinatedHydrocarbons, HalogenatedPropionatesAcids, AcyclicCarboxylic AcidsPiperidinesHeterocyclic Compounds, 1-RingHeterocyclic Compounds

Study Officials

  • Jin Liu, MD, PhD

    Department of Anesthesiology, West China Hospital

    STUDY CHAIR

Central Study Contacts

Guizhi Du, MD, PhD

CONTACT

Study Design

Study Type
observational
Observational Model
CASE CONTROL
Time Perspective
PROSPECTIVE
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

June 12, 2017

First Posted

June 21, 2017

Study Start

September 1, 2017

Primary Completion

October 1, 2018

Study Completion

October 1, 2023

Last Updated

November 6, 2017

Record last verified: 2017-06

Data Sharing

IPD Sharing
Will share

All the study outcomes

Locations