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ong term outcomes of Endoscopic Intermuscular Dissection for stage I rectal carcinomas

Conditions
T1 rectal cancer
Registration Number
NL-OMON24409
Lead Sponsor
MC Utrecht
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Pending
Sex
Not specified
Target Recruitment
140
Inclusion Criteria

In order to be eligible to participate in this study, a subject must meet all of the following criteria:
-Adult patients with a suspected T1 CRC with deep submucosal invasion based on optical diagnosis, using JNET 3, NICO III or Hiroshima C2-C3 classification, or > 40% with the OPTICAL model.
-A T1 rectal cancer located at or under the sigmoid take-off on the MRI
-At least 5 mm between the dentate line and the carcinomatous part of the polyp
-Written informed consent

Exclusion Criteria

A potential subject who meets any of the following criteria will be excluded from participation in this study:
-Age < 18 years
-Unable to complete quality of life questionnaires at baseline and 1e follow-up, or sign informed consent
-Treatment of a AJCC stage III or IV CRC within the last 5 years
-A suspicious peri-rectal lymph node of > 9 mm on the preprocedural MRI.
-A T1 CRC extending above the sigmoid take-off on MRI

Study & Design

Study Type
Observational non invasive
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
1)The proportion of histology confirmed (R0) resections of deep submucosal (T1) invasive rectal carcinomas with R0 defined as a minimal of 0.1 mm tumor free deep resection margin <br>2)The 3 and 5 years recurrence rate defined as either a local regrowth, LNM during or distant metastasis during follow-up of an R0 resection of a T1 CRC without the histological risk factors lymphovascular invasion, tumor budding or poor differentiation. <br>
Secondary Outcome Measures
NameTimeMethod
1)The quality of completion TME surgery after EID <br>2)The proportion curative resections defined as an R0 resection without the histological risk factors lymphovascular invasion, poor (G3) differentiation and/or high grade (BD2-3) tumor budding <br>3)Technical success of the EID in achieving an en bloc resection through the intermuscular plane, leaving the longitudinal muscle layer intact<br>4)Adverse outcomes after EID defined by any EID related AE or mortality within 30 days. The AE will be recorded according the ASGE lexicon.<br>5)All costs of the procedure will be recorded, as well as hospital stay, and re-intervention or re-admission for complications. <br>6)Quality of life (QLQ-C30, QLQ-C29, and EQ-5D-5L)<br>7)Functional outcome (COREFO and LARS score)<br>8)Sensitivity, specificity, negative and positive predictive value will be determined of MRI for making the difference between T1 Sm2-3 versus T2, and nodal staging. <br>
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