Statistical Analysis Plan for the SANO-trial: Neoadjuvant Chemoradiotherapy Followed by Surgery Versus Active Surveillance for Oesophageal Cancer

Not Applicable

Active, not recruiting

• Conditions: Active Surveillance; Neoadjuvant Chemoradiotherapy; Esophageal Cancer; Surgical Oncology
• Interventions: Procedure: Active surveillance

• Registration Number: NCT05953181
• Lead Sponsor: Erasmus Medical Center

Brief Summary

An active surveillance approach is proposed after completion of neoadjuvant chemoradiotherapy (nCRT) for carcinoma of the oesophagus. In this SANO (i.e. Surgery As Needed for Oesophageal cancer) approach, surgical resection is offered only to patients in whom a locoregional regrowth is highly suspected or proven, without distant dissemination. Such an organ-preserving strategy can have great advantages, but is only justified if long-term survival is non-inferior to that of the current standard trimodality approach comprising neoadjuvant chemoradiotherapy followed by standard surgery. The aim of this study is to assess the (cost-)effectiveness (including non-financial costs and survival) of active surveillance for patients with squamous cell- or adenocarcinoma of the oesophagus or oesophago-gastric junction.

Detailed Description

Not available

Study Timeline

• Study Start: 2017-11-01
• Primary Completion: 2023-06-01
• Status Verified: 2023-07
• Study First Submitted: 2023-07-03
• Study First Submitted QC: 2023-07-11
• Last Update Submitted: 2023-07-11
• Study First Posted: 2023-07-20
• Last Update Posted: 2023-07-20
• Study Completion: 2026-06-01

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 776

Inclusion Criteria

• Patients who underwent or are planned to undergo neoadjuvant chemoradiotherapy according to CROSS and are planned to undergo potentially curative surgical resection for histologically proven oesophageal or junctional squamous cell carcinoma or adenocarcinoma are eligible. Whenever pathology is inconclusive but a multidisciplinary expert group concludes oesophageal carcinoma because of radiologically or endosonographically highly suspected lesions, patients are eligible for the study.
• Age ≥18;
• Written, voluntary, informed consent.

Exclusion Criteria

• Language difficulty, dementia or altered mental status prohibiting the understanding and giving of informed consent and to complete quality of life questionnaires;
• Non-FDG-avid tumour at baseline PET-CT scan;
• Initial treatment with endoscopic resection.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Standard esophagectomy	Active surveillance	-
Active surveillance	Active surveillance	-

Primary Outcome Measures

Name	Time	Method
Overall survival	the interval between the moment of achieving cCR (i.e. the moment the patient will start the intervention) and death or last follow-up, with a minimal follow-up of two years after reaching cCR.

Trial Locations

Locations (1)

Erasmus MC, University Medical Center; 🇳🇱 Rotterdam, Zuid-Holland, Netherlands