Esophagectomy: Sweet Versus Ivor-Lewis (ESVIL)
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Purpose
Esophageal carcinoma is an aggressive disease with a poor prognosis. Surgical resection remains the basic method of management of this malignancy. Although different approaches have been described for the surgical resection of esophageal cancer, there is no statistical evidence based on large scale prospective randomized trials with regard to the issue that which is the optimal surgical approach for esophageal cancer. The purpose of this study is to test two different approach of transthoracic esophagectomy (Right Side Thoracotomy plus Midline Laparotomy Approach: Ivor-Lewis Procedure and Left Side Thoracotomy Approach: Sweet Procedure) in middle or lower third intrathoracic esophageal cancer. This research is being done to see whether one approach is superior than the other approach with better long-term outcome and acceptable postoperative short-term outcome or not.
| Condition | Intervention | Phase |
|---|---|---|
|
Esophageal Neoplasms |
Procedure: Esophagectomy |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | A Phase Ⅲ Study of Left Side Thoracotomy Approach (Sweet Procedure) Versus Right Side Thoracotomy Plus Midline Laparotomy Approach (Ivor-Lewis Procedure) Esophagectomy in Middle or Lower Third Intrathoracic Esophageal Cancer |
- Disease free survival [ Time Frame: Jan 2010-Jan 2016 ] [ Designated as safety issue: Yes ]
- Overall survival [ Time Frame: Jan 2010-Jan 2016 ] [ Designated as safety issue: Yes ]
- postoperative morbidity and mortality [ Time Frame: Jan 2010-Jan 2016 ] [ Designated as safety issue: Yes ]
- Locoreginal recurrence and recurrence pattern [ Time Frame: Jan 2010-Jan 2016 ] [ Designated as safety issue: Yes ]
- quality of life [ Time Frame: Jan 2010-Jan 2016 ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 280 |
| Study Start Date: | May 2010 |
| Estimated Study Completion Date: | July 2016 |
| Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Ivor-Lewis Procedure
Arm A: Esophagectomy was conducted through right side thoracotomy plus midline laparotomy approach:Ivor-Lewis Procedure.
|
Procedure: Esophagectomy
Esophagectomy Through Right Side Thoracotomy plus Midline Laparotomy Approach: Ivor-Lewis Procedure VS Esophagectomy Through Left Side Thoracotomy Approach: Sweet Procedure
Other Names:
|
|
Active Comparator: Sweet Procedure
Arm B: Esophagectomy was conducted through left side thoracotomy or thoracoabdominal incision: Sweet Procedure
|
Procedure: Esophagectomy
Esophagectomy Through Right Side Thoracotomy plus Midline Laparotomy Approach: Ivor-Lewis Procedure VS Esophagectomy Through Left Side Thoracotomy Approach: Sweet Procedure
Other Names:
|
Show Detailed Description
Eligibility| Ages Eligible for Study: | 18 Years to 70 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with histologically proven squamous cell esophageal cancer
- Patients with cT1-T3/N0-N1 mid or distal third (inferior to carina and 3cm superior to cardia ) operable esophageal lesion. Staging investigations including esophagogastroscopy, chest and abdominal CT scan, barium swallow and selective endoscopic ultrasonography showing no evidence of invading adjacent structure such as spine, bronchus, pericardium , descending aorta and without enlargement cervical and celiac nodes (diameter of short axis greater than 1.5cm) measured at CT scans.
- Karnofsky performance status greater than or equal to 80%
- Pulmonary and cardiac function must be acceptable for surgery according to institutional standards.
- Acceptable hepatic, renal and bone marrow function
Exclusion Criteria:
- Patients with low performance status(Karnofsky score <80%)
- Past history of malignancy
- Stage investigations indicating unresectable advanced disease(T4 or M1a,M1b)
- Patients with any other serious underlying medical condition that would impair the ability of the patient to receive or comply with protocol treatment
- Patients medically unfit for surgical resection
- Patients with pulmonary reserve inadequate to undergo thoracotomy and extensive mediastinal lymphadenectomy.
- Patients with a significant history of unstable cardiovascular disease that in the opinion of the treating physician should preclude the patient from protocol treatment.
- Uncontrolled diabetes mellitus or uncontrolled infection, including HIV or interstitial pneumonia or interstitial fibrosis.
- Significant psychiatric illness that would interfere with patient compliance
- Patients with severe hepatic cirrhosis or with serious renal disease unacceptable for surgery
- Patients considered of salvage surgery after definitive chemoradiotherapy
- Patients after neoadjuvant chemoradiotherapy
- Patients above the age of 75 years
- Patients unreliable for follow up
Contacts and Locations
More Information
No publications provided
| Responsible Party: | Haiquan Chen MD, Fudan University Cancer Center |
| ClinicalTrials.gov Identifier: | NCT01047111 History of Changes |
| Other Study ID Numbers: | 201001ECFD |
| Study First Received: | January 11, 2010 |
| Last Updated: | February 26, 2013 |
| Health Authority: | China: Food and Drug Administration |
Keywords provided by Fudan University:
|
Esophageal Neoplasms Esophagectomy |
Additional relevant MeSH terms:
|
Neoplasms Esophageal Diseases Esophageal Neoplasms Gastrointestinal Diseases Digestive System Diseases |
Gastrointestinal Neoplasms Digestive System Neoplasms Neoplasms by Site Head and Neck Neoplasms |
ClinicalTrials.gov processed this record on June 18, 2013