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Ovarian CancerULTRA-LAPNCT05862740

ULTRA-LAP Trial: Laparoscopic Debulking Surgery (LDS) in Advanced Ovarian Cancer

A study testing Laparoscopic Debulking Surgery in advanced ovarian cancer and Standard laparotomic Debulking Surgery in advanced ovarian cancer in people with Ovarian Cancer, run by Azienda Ospedaliera di Padova at 1 site in Italy.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

ULTRA-LAP is a prospective study is to investigate the safety, efficacy and feasibility of laparoscopic debulking surgery (LDS) for the treatment of patients with advanced ovarian cancer. Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Ovarian Cancer
What is being tested?
Laparoscopic Debulking Surgery in advanced ovarian cancer and Standard laparotomic Debulking Surgery in advanced ovarian cancer
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
62 participants
Where
1 siteItaly
Study dates
2 Jan 2022to 31 Dec 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

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 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Patients with advanced epithelial ovarian cancer (II-IV Stage FIGO) candidates to PDS (primary debulking surgery) or IDS (interval debulking surgery: neoadjuvant chemotherapy followed by IDS).
  • Participant is willing and able to give informed consent for participation in the study.
  • Female aged 18 years or above.
  • Primary diagnosis of advanced epithelial ovarian cancer (tubal and peritoneal cancer included).

Who cannot join

  • Comorbidities non-allowing for radical surgery
  • Poor Performance Status (Karnofsky Index < 70)
  • Concomitant or past history of malignancy, regardless of treatment status
  • Recent or past story of pancreatitis or hepatitis
  • Recent or past story of pleural effusion or lung injuries or respiratory failure
  • Cardiac major pathologies

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Matteo Marchetti, Doctor contact

0039-049-8213445

matteomarchetti91@gmail.com

Marco Noventa, Doctor contact

0039-049-8213445

marco.noventa@gmail.com

Italy1 site, 1 recruiting
  • Azienda Ospedaliera Universitaria di Padova,

    Padova, Padova, Veneto, 35128

    Matteo Marchetti, MD, matteomarchetti91@gmail.com

    Marco Noventa, MD, marco.noventa@gmail.com

    Recruiting

Other trials in Italy

About this study

Official title: ULTRA-LAP Trial: Laparoscopic Debulking Surgery (LDS) in Advanced Ovarian Cancer: a Feasibility Prospective Study

ULTRA-LAP is a prospective study is to investigate the safety, efficacy and feasibility of laparoscopic debulking surgery (LDS) for the treatment of patients with advanced ovarian cancer.

The outcomes to measure are:

Read more
  • Safety: the rate of patients experiencing intra- and post-operative early and late morbidities (within the hospitalization and up to 60 days from surgery)
  • Efficacy: the rate of patients in which the surgical target set pre-operatively (complete resection) is achieved by laparoscopy.
  • Feasibility: the rate of patients who have their procedure completed by laparoscopy

Patients will undergo laparoscopic debulking surgery (LDS) if the surgical target can be met. If it cannot be achieved by laparoscopy the surgeon will convert to laparotomy.

Read the detailed description

The investigators intend to perform a prospective feasibility study on patients with primary diagnosis of advanced ovarian cancer (stage II to IV according to FIGO classification) who are referred to the tertiary cancer centre of the study. The latter is the Department of Gynecology and Obstetrics - Division of Women's and Children's Health - University of Padova - Italy. The statistical sample size calculation identified a minimum of 62 patients. The anticipated enrollment period will be about 4 years.

To confirm the ultimate eligibility to surgery and recruitment in the study, all patients undergo an exploratory laparoscopy (EXL).

The ideal surgical target is complete resection (CR) of all visible disease. Patients who are deemed not amenable to a CR at EXL will start neo-adjuvant chemotherapy. They will be reconsidered for the ULTRA-LAP study at time of interval surgery after 3 cycles of chemotherapy. Criteria for eligibility after neo-adjuvant chemotherapy are the same as per up-front surgery.

All patients recruited in the ULTRA-LAP trial will be discussed at Gynaecologic Oncology Multidisciplinary team (MDT) meeting, where imaging is reviewed and management is agreed. Following MDT decision:

  • A Gynaecologic Oncologist will discuss the standard management and the ULTRA-LAP trial at time of out-patient clinic
  • The ULTRA-LAP leaflet and consent form will be provided to the patient together with an accurate explanation of the study
  • If the patient accepts to enter the study, a study registration form will be filled
  • Participation in the study will be confirmed and the forms signed at time of pre-operative assessment and again confirmed at time of in-patient admission ULTRA-LAP trail will include all surgical procedures necessary to accomplish a complete resection (CR) of disease. The most common procedures necessary to obtain a CR are defined by The European Society of Gynaecological Oncology (ESGO), Society of Gynecologic Oncology (SGO) and the The National Institute for Health and Care Excellence (NICE) guidelines. All procedures will be performed by an expert Gynaecologic Oncologist with proven experience and high skills levels in oncological surgery. Once the surgeon realizes that a CR could not be achieved by laparoscopy, but prove to be feasible by laparotomy, the surgery is immediately converted to laparotomy.

Subsequent follow-up:

  1. During Recovery:
  • The patients are going to be monitored daily and any relevant complications will be registered, graded (according to Clavien-Dindo classification) and treated.
  1. Post recovery:
  • 1 st follow-up visit: At time of hospital's discharge an examination will be performed and, if necessary, further exams will be prescribed as appropriate.
  • 2 nd follow-up visit: following discharge, the next appointment is in the outpatient clinic roughly 15-20 days from the surgery.
  • 3 rd and last visit: at 30 days from the surgery a further appointment will be carried.

At each follow-up appointment the following will be registered:

  • Occurrence of complications
  • Physical examination
  • Changes in normal quality of life.

Achievement of a CR will be determined at time of surgery and confirmed by a pre-chemotherapy CT scan. Should discrepancy arise, CT scan will be reviewed at MDT.

All patients will be closely monitored with a rigorous follow-up program every 90 days for the first two years and then every 120 days for the subsequent 2 years. In addition, all patient could contact the department if any unexpected complications happens between follow-up time.

Conditions
Ovarian Cancer
Being tested
Laparoscopic Debulking Surgery in advanced ovarian cancer, Standard laparotomic Debulking Surgery in advanced ovarian cancer
Keywords
Ovarian cancer, Advanced ovarian cancer, Debulking surgery, Multivisceral surgery, Laparoscopic debulking surgery
Medical subject headings
Ovarian Neoplasms

What participants receive

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

  • Laparoscopic Debulking Surgery in advanced ovarian cancerProcedure or surgery

    Laparoscopic debulking will be conducted until the surgical target is achieved or the operation is converted to laparotomy.

  • Standard laparotomic Debulking Surgery in advanced ovarian cancerProcedure or surgery

    Debulking by laparotomy in patients when debulking could not be accomplished by laparoscopy.

Study groups in NCT05862740
Study groupRoleWhat they receive
Laparoscopic debulking surgery - LDSExperimentalPrimary debulking surgery or Interval debulking surgery performed by laparoscopy (P-LDS and I-LDS)
Receives: Procedure: Laparoscopic Debulking Surgery in advanced ovarian cancer
Debulking surgery - DSActive comparatorPrimary debulking surgery or Interval debulking surgery performed by/converted to laparotomy (PDS and IDS)
Receives: Procedure: Standard laparotomic Debulking Surgery in advanced ovarian cancer

What is being measured

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

  1. Safety: rate of complications/morbidities

    Safety will be measured as the rate of patients experiencing intra- and post-operative early and late morbidities (within and after the hospitalization up to 60 days from surgery) and it will be compared to the morbidity rate of patients having similar surgery by laparotomy. Complications are going to be graded according to Clavien-Dindo classification.

    Measured: 60 days

  2. Efficacy: rate of complete resection (CR) in group 1

    Efficacy will be measured as the rate of patients in which the surgical target set pre-operatively is achieved by laparoscopy.

    Measured: 60 days

  3. Feasibility: rate of procedures completed by laparoscopy

    Feasibility will be measured as the rate of patients who have their procedure completed by laparoscopy.

    Measured: 60 days

Secondary outcomes (2)
  1. Progression Free Survival (PFS).

    the time interval from the surgical treatment to the date of the documented first recurrence of disease, by CA 125 (Carbohydrate Antigen 125) and/or CT scan.

    Measured: 5 years

  2. Overall Survival (OS).

    time between surgery and death.

    Measured: 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 posted17 May 2023
  2. Study start2 Jan 2022
  3. Primary completion31 Dec 2026 (estimated)
  4. Study completion31 Dec 2027 (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 N/A
Primary purpose
Treatment
Allocation
Non-randomised
Intervention model
Factorial
Model description
Group A is the study group (completed laparoscopic debulking); Group B (conversion to laparotomy) is the control group in which laparoscopy could not be completed
Masking
None (open label)
Enrolment
62 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05862740
Sponsor's protocol ID
5497/AO/22
Other IDs
AOP2674
Acronym
ULTRA-LAP
Status last verified
May 2023
First submitted
10 Mar 2023
Last updated
17 May 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Elattar A, Bryant A, Winter-Roach BA, Hatem M, Naik R. Optimal primary surgical treatment for advanced epithelial ovarian cancer. Cochrane Database Syst Rev. 2011 Aug 10;2011(8):CD007565. doi: 10.1002/14651858.CD007565.pub2.

    PubMed 21833960
  • Shih KK, Chi DS. Maximal cytoreductive effort in epithelial ovarian cancer surgery. J Gynecol Oncol. 2010 Jun;21(2):75-80. doi: 10.3802/jgo.2010.21.2.75. Epub 2010 Jun 30.

    PubMed 20613895
  • Elstrand MB, Sandstad B, Oksefjell H, Davidson B, Trope CG. Prognostic significance of residual tumor in patients with epithelial ovarian carcinoma stage IV in a 20 year perspective. Acta Obstet Gynecol Scand. 2012 Mar;91(3):308-17. doi: 10.1111/j.1600-0412.2011.01316.x. Epub 2012 Jan 9.

    PubMed 22050605
  • Pomel C, Akladios C, Lambaudie E, Rouzier R, Ferron G, Lecuru F, Classe JM, Fourchotte V, Paillocher N, Wattiez A, Montoriol PF, Thivat E, Beguinot M, Canis M. Laparoscopic management of advanced epithelial ovarian cancer after neoadjuvant chemotherapy: a phase II prospective multicenter non-randomized trial (the CILOVE study). Int J Gynecol Cancer. 2021 Dec;31(12):1572-1578. doi: 10.1136/ijgc-2021-002888. Epub 2021 Oct 20.

    PubMed 34670829
  • Fagotti A, Gueli Alletti S, Corrado G, Cola E, Vizza E, Vieira M, Andrade CE, Tsunoda A, Favero G, Zapardiel I, Pasciuto T, Scambia G. The INTERNATIONAL MISSION study: minimally invasive surgery in ovarian neoplasms after neoadjuvant chemotherapy. Int J Gynecol Cancer. 2019 Jan;29(1):5-9. doi: 10.1136/ijgc-2018-000012.

    PubMed 30640676
  • Tozzi R, Noventa M, Saccardi C, Spagnol G, De Tommasi O, Coldebella D, Marchetti M. Feasibility of laparoscopic Visceral-Peritoneal Debulking (L-VPD) in patients with stage III-IV ovarian cancer: the ULTRA-LAP trial pilot study. J Gynecol Oncol. 2024 Mar;35(2):e14. doi: 10.3802/jgo.2024.35.e14. Epub 2023 Oct 16.

    PubMed 37921599

Questions about this trial

What is this clinical trial studying?

A study testing Laparoscopic Debulking Surgery in advanced ovarian cancer and Standard laparotomic Debulking Surgery in advanced ovarian cancer in people with Ovarian Cancer, run by Azienda Ospedaliera di Padova at 1 site in Italy.

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 4 inclusion and 6 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: looking for participants now, as of the sponsor's last update on 17 May 2023. 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 Italy. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Matteo Marchetti, Doctor (0039-049-8213445, matteomarchetti91@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety: rate of complications/morbidities (time frame: 60 days). The study lists 3 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 NCT05862740, which also lists 6 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 17 May 2023; AzTrials last refreshed its copy on 6 Nov 2026.

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