AzTrials
AzTrials

Stomach NeoplasmsPhase 3NCT01911832

Impact of Gastric Tube Reconstruction Widths on Quality of Life for Esophagogastric Cancers

A Phase 3 study testing esophagojejunostomy after total gastrectomy, Roux-en-Y gastrojejunostomy after subtotal gastrectomy and wide tube reconstruction after subtotal gastrectomy in people with Stomach Neoplasms and Esophageal Neoplasms, run by West China Hospital at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
Search all trials

Trial summary

The incidence of cancer of the esophagogastric junction has rapidly risen in recent three decades, and surgery still remains the optimum therapy. For Siewert's type II and III cancer, esophagojejunostomy after total gastrectomy and Roux-en-Y gastrojejunostomy after subtotal gastrectomy are regarded as the two main… Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Stomach Neoplasms, Esophageal Neoplasms
What is being tested?
esophagojejunostomy after total gastrectomy, Roux-en-Y gastrojejunostomy after subtotal gastrectomy and wide tube reconstruction after subtotal gastrectomy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteChina
Study dates
Mar 2012to Feb 2017
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • pathologically confirmed esophagogastric cancers
  • age between 18 to 80 years
  • no evidence of metastasis of adjacent organs
  • organs function well to tolerate surgery
  • no special treatment before surgery
  • informed consent was written

Who cannot join

  • with other site tumor,simultaneously
  • locally recurrent gastric or esophageal cancer
  • had a history of malignant tumor within 5 years(except the skin cancer)
  • pregnant or lactating women
  • there was contraindication for operation
  • discovery of metastasis in the operation
  • with mental disorder

Trial locations and contacts

1 site in 1 country.

Wei M tian, M.D. contact

+8613198596090

m.weihx@gmail.com

Deng X bing, M.D. contact

+8613730677124

xiangbingdeng@gmail.com

China1 site, 1 recruiting
  • West China hospital, Sichuan University

    Chengdu, Sichuan, 610000

    Wang Z qiang, PhD,MD, +8618980602028, wzqtrial@gmail.com

    Zhang Y chuan, +8613880412932, 20874185@qq.com

    Recruiting

Other trials in China

About this study

Official title: Impact of Widths After Gastric Tube Reconstruction on Quality of Life for Patients With Esophagogastric Cancers

The incidence of cancer of the esophagogastric junction has rapidly risen in recent three decades, and surgery still remains the optimum therapy. For Siewert's type II and III cancer, esophagojejunostomy after total gastrectomy and Roux-en-Y gastrojejunostomy after subtotal gastrectomy are regarded as the two main surgical approaches. Esophagojejunostomy after total gastrectomy brings high survival rate and low local recurrence rate which may also induces pulmonary infection or regurgitation. Roux-en-Y gastrojejunostomy after subtotal gastrectomy needs reconstruction of the gastric tube and the width of reconstruction tube was a key factor to predicate prognosis. However, no evidence supplies a comprehensive standard on the width of reconstruction tube which often ranges from 3 cm to 6 cm. Both narrow and wide reconstruction tubes have their own advantages and disadvantages. So the prospective trail recruits patients into three groups: total gastrostomy group (TG group), wide gastric tube group (WG group) and narrow gastric tube group (NG group). And the investigators compare the quality of life using integrated questionnaire of QLQ-STO22 and QLQ-C30 and related symptom relief as main endpoints.

Read the detailed description

With the decreasing prevalence of gastric cancer, the incidence of cancer of the esophagogastric junction has rapidly risen in recent three decades, especially in North America and Europe. Despite the use of chemotherapy, its 5-year survival rate is still low (less than 30%) for cancer of the esophagogastric junction. Surgery still remains the optimum therapy for cancer of the esophagogastric junction. For Siewert's type II and III cancer, esophagojejunostomy after total gastrectomy and Roux-en-Y gastrojejunostomy after subtotal gastrectomy are regarded as the two main surgical approaches. For quality of life, no prospective trial provides evidence comparing the two approaches.

With a complete clearance of lymph nodes, esophagojejunostomy after total gastrectomy brings high 5-year survival rate, and can decrease the rate of local recurrence. However, due to the whole gastrectomy, the patients often represent bile regurgitation which may induce pulmonary infection, regurgitation asthma and weight loss.

Roux-en-Y gastrojejunostomy after subtotal gastrectomy reserve partial gastric body which was reconstructed into gastric tube. The remaining gastric body still peristalses and functions as well as a stomach. At the same time, the remaining gastric body keeps acid-secreting function which may induce acid regurgitation after surgery.

For Roux-en-Y gastrojejunostomy after subtotal gastrectomy, the width of reconstruction gastric tube was a key factor to predicate prognosis, and it often ranges from 3 cm to 6 cm, without universal standard. Narrow gastric tube may lack enough blood supply, as a result, it increase the rate of anastomotic leakage. On the contrary, wide gastric tube takes up much thoracic capacity which may disturb the normal pulmonary and cardiovascular function. Tabira and his colleagues conduct a prospective trail that proves the width of gastric tube has no relevance to local blood supply, anastomotic leakage and postoperative nutrition, but the study lack enough patients which may increase bias. So, there is no reliable evidence to predict the quality of postoperative life.

The prospective trail recruits patients with of cancer of the esophagogastric junction. And eligible patients were assigned into three groups: total gastrostomy group (TG group), wide gastric tube group (WG group) and narrow gastric tube group (NG group). Quality of life include integrated questionnaire of QLQ-STO22 and QLQ-C30 and related symptom relief was assessed as primary endpoint. And local recurrence, disease free survival, metastatic rate, overall survival and short-term complication of surgery were also observed as secondary endpoints.

Being tested
esophagojejunostomy after total gastrectomy, Roux-en-Y gastrojejunostomy after subtotal gastrectomy, wide tube reconstruction after subtotal gastrectomy, narrow tube reconstruction after subtotal gastrectomy
Keywords
Cancer of the esophagogastric junction, Reconstruction of gastric tube, Quality of life, Width, Regurgitation
Medical subject headings
Stomach Neoplasms, Esophageal Neoplasms, Gastroesophageal Reflux

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • esophagojejunostomy after total gastrectomyProcedure or surgery

    Also called total gastrostomy group(TG group)

  • Roux-en-Y gastrojejunostomy after subtotal gastrectomyProcedure or surgery

    Also called subtotal gastrectomy(SG group)

  • wide tube reconstruction after subtotal gastrectomyProcedure or surgery

    Also called wide gastric tube group(WG group)

  • narrow tube reconstruction after subtotal gastrectomyProcedure or surgery

    Also called narrow gastric tube group(NG group)

Study groups in NCT01911832
Study groupRoleWhat they receive
Gastrectomy and subtotal gastrectomyExperimentalto compare the quality of life between esophagojejunostomy after total gastrectomy(TG group) and Roux-en-Y gastrojejunostomy after subtotal gastrectomy(SG group)
Receives: Procedure: esophagojejunostomy after total gastrectomy; Procedure: Roux-en-Y gastrojejunostomy after subtotal gastrectomy
Wide and narrow reconstruction tubeExperimentalto compare the quality of life between wide tube reconstruction after subtotal gastrectomy(WG group) and narrow tube reconstruction after subtotal gastrectomy(NG group) in Roux-en-Y gastrojejunostomy
Receives: Procedure: wide tube reconstruction after subtotal gastrectomy; Procedure: narrow tube reconstruction after subtotal gastrectomy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. quality of life

    quality of life include: 1)integrated questionnaire of QLQ-STO22 and QLQ-C30. 2)related symptom relief of regurgitation, dysphagia and heartburn et al.

    Measured: 3 years

Secondary outcomes (5)
  1. local recurrence

    Measured: 1 year

  2. disease free survival

    the time from operation to confirmed local recurrence, distant metastases, or death due to disease or treatment, whichever occurred first

    Measured: 1 year

  3. metastatic rate

    ratio of the patients with metastasis after the operation

    Measured: 1 year

  4. overall survival

    the fraction of the person from the operation the death,no matter the reason of the death.

    Measured: 1 and 3 years

  5. short-term complication of the surgery

    complication including pulmonary infection, bleeding and anastomotic leakage et al.

    Measured: first 30 day after operation

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Jul 2013 (estimated)
  2. Study startMar 2012
  3. Primary completionFeb 2017 (estimated)
  4. Study completionFeb 2017 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01911832
Sponsor's protocol ID
WqLE-201324
Status last verified
Sep 2016
First submitted
22 Jul 2013
Last updated
13 Sep 2016
Results posted
No
Data monitoring committee
Yes

Publications

  • Vial M, Grande L, Pera M. Epidemiology of adenocarcinoma of the esophagus, gastric cardia, and upper gastric third. Recent Results Cancer Res. 2010;182:1-17. doi: 10.1007/978-3-540-70579-6_1.

    PubMed 20676867
  • Hasegawa S, Yoshikawa T. Adenocarcinoma of the esophagogastric junction: incidence, characteristics, and treatment strategies. Gastric Cancer. 2010 Jun;13(2):63-73. doi: 10.1007/s10120-010-0555-2. Epub 2010 Jul 3.

    PubMed 20602191
  • Allum WH, Stenning SP, Bancewicz J, Clark PI, Langley RE. Long-term results of a randomized trial of surgery with or without preoperative chemotherapy in esophageal cancer. J Clin Oncol. 2009 Oct 20;27(30):5062-7. doi: 10.1200/JCO.2009.22.2083. Epub 2009 Sep 21.

    PubMed 19770374
  • Mariette C, Piessen G, Briez N, Gronnier C, Triboulet JP. Oesophagogastric junction adenocarcinoma: which therapeutic approach? Lancet Oncol. 2011 Mar;12(3):296-305. doi: 10.1016/S1470-2045(10)70125-X. Epub 2010 Nov 23.

    PubMed 21109491
  • Johansson J, Djerf P, Oberg S, Zilling T, von Holstein CS, Johnsson F, Walther B. Two different surgical approaches in the treatment of adenocarcinoma at the gastroesophageal junction. World J Surg. 2008 Jun;32(6):1013-20. doi: 10.1007/s00268-008-9470-7.

    PubMed 18299921
  • Ielpo B, Pernaute AS, Elia S, Buonomo OC, Valladares LD, Aguirre EP, Petrella G, Garcia AT. Impact of number and site of lymph node invasion on survival of adenocarcinoma of esophagogastric junction. Interact Cardiovasc Thorac Surg. 2010 May;10(5):704-8. doi: 10.1510/icvts.2009.222778. Epub 2010 Feb 13.

    PubMed 20154347
  • De Giacomo T, Francioni F, Venuta F, Trentino P, Moretti M, Rendina EA, Coloni GF. Complete mechanical cervical anastomosis using a narrow gastric tube after esophagectomy for cancer. Eur J Cardiothorac Surg. 2004 Nov;26(5):881-4. doi: 10.1016/j.ejcts.2004.07.024.

    PubMed 15519175
  • Matsuda T, Kaneda K, Takamatsu M, Takahashi M, Aishin K, Awazu M, Okamoto A, Kawaguchi K. Reliable preparation of the gastric tube for cervical esophagogastrostomy after esophagectomy for esophageal cancer. Am J Surg. 2010 May;199(5):e61-4. doi: 10.1016/j.amjsurg.2009.08.046. Epub 2010 Mar 3.

    PubMed 20202621
  • Pierie JP, de Graaf PW, van Vroonhoven TJ, Obertop H. The vascularization of a gastric tube as a substitute for the esophagus is affected by its diameter. Dis Esophagus. 1998 Oct;11(4):231-5. doi: 10.1093/dote/11.4.231.

    PubMed 10071804
  • Tabira Y, Sakaguchi T, Kuhara H, Teshima K, Tanaka M, Kawasuji M. The width of a gastric tube has no impact on outcome after esophagectomy. Am J Surg. 2004 Mar;187(3):417-21. doi: 10.1016/j.amjsurg.2003.12.008.

    PubMed 15006575

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing esophagojejunostomy after total gastrectomy, Roux-en-Y gastrojejunostomy after subtotal gastrectomy and wide tube reconstruction after subtotal gastrectomy in people with Stomach Neoplasms and Esophageal Neoplasms, run by West China Hospital at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 13 Sep 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Wei M tian, M.D. (+8613198596090, m.weihx@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

quality of life (time frame: 3 years). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01911832, which also lists 10 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 Sep 2016.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in