Surgery Versus Endoscopic Resection for Incompletely Removed Early Colon CAnceR
Recruiting · NCT06057350 · Interventional (participants receive a specific treatment) · Lead sponsor: Norwegian Department of Health and Social Affairs
View the official record on ClinicalTrials.gov →Interventions studied
What this trial is about
Randomized head-to-head comparison trial among patients who have undergone incomplete endoscopic resection of early colon cancer to evaluate the benefits, harms and burdens, as well as the ecological footprint and cost-effectiveness of endoscopic full thickness resection (eFTR), a minimally invasive endoscopic treatment with a colonoscope, as compared to standard-of-care surgery. Co-primary endpoints are * Rate of severe adverse events classified as grade III to V according to the Clavien Dindo classification within 30-days after study treatment * CRC recurrence or sign of lymph nodes or distant metastases at 3 years after randomization comparing the two treatment groups (eFTR versus surgery).
Who can take part
Inclusion criteria
- Men and women, age 40 years or older with endoscopic removal (snare or forceps polypectomy; endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) with R1 (resection margin \<0.1mm23,40) or Rx resection margins of colon cancer (location proximal to the rectum (12 cm or more from the anal verge))
- No contraindication for colon surgery as deemed by the multidisciplinary tumor board (MTB) at the participating centre
- Absence of the following histopathological tumor features: poor differentiation, lymphovascular invasion, tumor budding grade B2-B3.
- No sign of disease beyond stage T1N0M0 on standard-of-care computed tomography imaging of the thorax, abdomen and pelvis41 and clinical evaluation
- Identifiable resection site with colonoscopy, either by visualizing a previously administered tattoo or by identification of a scar in the correct colon segment
- No other tumors or polyps larger than 10 mm in diameter in the colorectum at time of randomization
- Complete colonoscopy with adequate quality of bowel preparation (Boston Bowel Preparation Scale score ≤2 in all colonic segments) and photo or video documentation of the appendiceal orifice or ileocecal valve.
- No colonic strictures or severe diverticulosis.
- No prior CRC
- No other malignant disease which is not deemed cured
- No confirmed or suspected genetic cancer syndrome (10 or more adenomas/serrated lesions, adenomatous or serrated polyposis syndrome; Lynch or Lynch-like syndrome)
- No inflammatory bowel disease
- Written informed consent provided by before enrolment
Exclusion criteria
- all who do not fulfill inclusion criteria
Where it is running
3 locations listed.
- Akershus University Hospital - Oslo, Norway
- Maria Sklodowska-Curie National Research Institute of Oncology - Warsaw, Poland
- Vestre Viken Hospital - Oslo, Akershus, Norway