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Colorectal Cancer MetastaticNCT03193710

The Effects of General Anesthetics on Lymphocytes in Patients Undergoing Colorectal Cancer Resection and Mechanism Involved

An observational study of Colorectal Cancer Metastatic and Survival Rate, run by Guizhi Du 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 The sponsor has not verified this record for over two years, so it may be out of date.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
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Trial 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. Read more about this study

Who is it for?
Ages 18 to 65 years
What is being tested?
Propofol, Sevoflurane and Remifentanil
Type of treatment
Injection or infusion
How many people
260 participants
Where
1 siteChina
Study dates
1 Sep 2017to Oct 2023
Phase
Observational
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 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Patients with colonal or rectal cancer undergoing cancer resection with general anesthesia

Who may be able to join

  • 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.

Who cannot join

  • 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
Show all 10Show fewer
  • 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

Trial locations and contacts

1 site in 1 country.

Guizhi Du, MD, PhD contact

+8618980602213

du_guizhi@yahoo.com

Jin Liu, MD, PhD contact

+86 18980601549

scujinliu@foxmail.com

China1 site, 1 recruiting
  • West China Hospital of Sichuan University, Department of Anesthesiology

    Chengdu, Sichuan, 610041

    Guizhi Du, MD, PhD, +86-189-8060-2213, du_guizhi@yahoo.com

    Guizhi Du, MD, PhD

    Recruiting

Other trials in China

About this study

Official title: Comparison of the Effects of Total Intravenous Anesthesia and Inhalation Anesthesia on Lymphocytes in Patients Undergoing Colorectal Cancer Resection and the Mechanism Involved: a Single-center, Randomized, Prospective Study

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.

Read the detailed description

With the increasing number of patients diagnosed with colorectal cancer, the proportion of patients undergoing surgical resection with general anesthesia increased. However, the operation can lead tumor cells releasing into the blood or peritoneal implantation, and the impaired immune response can make patients susceptible to the development of tumor metastasis and recurrence which is the the main reason of death. It is well known that B lymphocytes and T lymphocytes are the main immune cells, and B lymphocytes by secreting antibodies are related to humoral immunity and T lymphocytes which play the most important role in antitumor are related to cell-mediated immunity. Surgery stress leads to metabolic and neuroendocrine changes causing significant depression of immunity. Although general anesthesia could reduce surgical stress, studies indicated general anesthetics including intravenous and inhalational agents both have variable effects on tumor cells growth by immuno-modulation and some cytokines. A number of studies have demonstrated deleterious effects on the function of lymphocytes associated with the administration of volatile inhalational anesthetic agents. It was suggested that the use of volatile inhalational agent may augment tumor cells growth by inhibiting the activity of lymphocytes, NK cells and dendritic cells which are important for recognizing, capturing and killing tumor cells, however, the alternative propofol has a converse (beneficial) effect by decreasing the plasma level of cytokines secreted by activated lymphocytes, macrophages and NK cells. The detailed mechanism of how volatile anesthetics affect the activity of antitumor cells remains unknown. Thus the investigators will conduct the clinical investigation to study the effect of volatile anesthetics on the immune response and metastasis in patients undergoing colorectal cancer resection, exploring molecular mechanism involved if inhalational anesthetics show an effect. The findings of this study would be valuable for anesthetic regimen guidance of colorectal cancer patients undergoing surgical resection in terms of long-term survival.

Keywords
Intravenous anesthesia, Inhalational anesthesia, Colorectal cancer resection, Lymphocytes, Metastasis, Survival, Molecular mechanism
Medical subject headings
Neoplasm Metastasis

What participants receive

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

  • PropofolDrug

    Also called Diprivan

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

  • SevofluraneDrug

    Also called Abbvie

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

  • RemifentanilDrug

    Also called YiChang HumanWell Pharmaceutical Co.,LTD. China

    Remifentanil will be used for analgesia in both groups.

Study groups in NCT03193710
Study groupRoleWhat they receive
Total intravenous anesthesia groupThe anesthesia of patients in the total intravenous anesthesia group will be maintained with propofol and remifentanil.
Receives: Drug: Propofol; Drug: Remifentanil
Inhalational anesthesia groupThe anesthesia of patients in the inhalational anesthesia group will be maintained with sevoflurane and remifentanil.
Receives: Drug: Sevoflurane; Drug: Remifentanil

What is being measured

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

  1. 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

    Measured: up to 5 years

  2. Cancer free survival

    Patients who remain alive without known colonal or rectal tumor recurrence

    Measured: 5 years or as available

Secondary outcomes (9)
  1. Cancer recurrence rate

    Patients who remain alive with known colonal or rectal tumor recurrence

    Measured: up to 5 years

  2. Cancer metastasis rate

    Patients who remain alive with known colonal or rectal tumor metastasis

    Measured: up to 5 years

  3. Re-operation

    Patients who have a surgery under general anesthesia

    Measured: up to 5 years

  4. Anesthesia scheme for re-operation

    Total intravenous anesthesia, inhalational anesthesia or combined anesthesia

    Measured: up to 5 years

  5. Radiotherapy rate for any cancer

    Patients have radiotherapy for any cancer

    Measured: up to 5 years

  6. Chemotherapy rate for any cancer

    Patients have chemotherapy for any cancer

    Measured: up to 5 years

  7. Circulating tumor cells

    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 circulating tumor cells

    Measured: up to 5 years

  8. Concentration of cytokines

    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 IL, TNF-α, IFN-γ and GCSF

    Measured: up to 5 years

  9. Colorectal cancer antibodies

    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 CEA, CA199, GP87 and TPA.

    Measured: up to 5 years

Timeline

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

  1. First posted21 Jun 2017
  2. Study start1 Sep 2017
  3. Primary completionOct 2018 (estimated)
  4. Study completionOct 2023 (estimated)

Resources

More details

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

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
260 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03193710
Sponsor's protocol ID
WestChinaHospital
Status last verified
Jun 2017
First submitted
12 Jun 2017
Last updated
6 Nov 2017
Results posted
No
Data monitoring committee
Yes
Individual data sharing
Yes: All the study outcomes

Publications

  • 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.

    PubMed 23374147
  • 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.

    PubMed 26497059
  • 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.

    PubMed 23166149
  • 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.

    PubMed 25009197
  • 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.

    PubMed 25009196
  • 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.

    PubMed 26556730
  • 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.

    PubMed 26425050
  • 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.

    PubMed 18823665
  • 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.

    PubMed 25548913
  • 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.

    PubMed 27374629

Questions about this trial

What is this clinical trial studying?

An observational study of Colorectal Cancer Metastatic and Survival Rate, run by Guizhi Du 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 5 inclusion and 10 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 6 Nov 2017. 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.

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 Guizhi Du, MD, PhD (+8618980602213, du_guizhi@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from baseline lymphocytes within postoperative 5 years (time frame: up to 5 years). The study lists 2 primary outcomes in all. 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 NCT03193710, 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 6 Nov 2017.

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