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Robotic, Laparoscopic and Open Gastrectomy Compared on Short and Long Term Outcomes

Recruiting
Conditions
Gastric Cancer
Interventions
Procedure: Robotic Gastrectomy
Procedure: Laparoscopic Gastrectomy
Registration Number
NCT02751086
Lead Sponsor
International Study Group on Minimally Invasive Surgery for Gastric Cancer
Brief Summary

The overall purpose is to develop and maintain a multi-institutional database comprising of information regarding surgical, clinical and oncological features of patients that will be treated for gastric cancer with robotic, laparoscopic or open approaches and subsequent follow-up.

The main objective is to compare the three surgical arms on surgical and clinical outcomes, as well as on the oncological follow-up.

Detailed Description

A review of the scientific literature, which was recently published by the IMIGASTRIC study group, aimed to perform a more complete analysis of the current situation regarding performing minimally invasive surgery for gastric cancer. Significant limitations were found in the analyzed studies, including:

* Small samples of patients, mostly low-quality comparative studies

* Selection bias in the comparison groups (e.g. stage, extent of lymphadenectomy)

* Absence of subgroup analysis in significant research fields

* Lack of information on the surgical techniques adopted

A large prospective multicenter registry could thus be the optimal way to clarify the role of minimally invasive surgery for gastric cancer and permit the evaluation of its short and long-term effects. A working basis for analyzing outcomes of interest and obtaining directions for guidelines and future study developments can also be created. The following would be the main advantages of a large prospective multicenter registry:

* Achieving a large sample of patients

* Collecting multiple variables, allowing for the making of a comprehensive statistical report

* Standardizing the methodology to be adopted, thus increasing accuracy

* Bringing together the experiences of both East and West to discover shared points A prospective registry can become a powerful tool that can guide research in this field to new developments and pave the way for other investigational opportunities.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
5000
Inclusion Criteria
  • Histologically proven gastric cancer
  • Preoperative staging work-up performed by upper endoscopy and/or endoscopic ultrasound, and CT scan and in accordance to international guidelines
  • Early Gastric Cancer
  • Advanced Gastric Cancer
  • Patients treated with curative intent in accordance to international guidelines
Exclusion Criteria
  • Distant metastases: peritoneal carcinomatosis, liver metastases, distant lymph node metastases, Krukenberg tumors, involvement of other organs
  • Patients with high operative risk as defined by the American Society of Anesthesiologists (ASA) score > 4
  • History of previous abdominal surgery for gastric cancer
  • Synchronous malignancy in other organs
  • Palliative surgery

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Robotic GastrectomyRobotic GastrectomyPatients who will be treated for gastric cancer with the assistance of the robotic surgical system
Laparoscopic GastrectomyLaparoscopic GastrectomyPatients who will be treated for gastric cancer through laparoscopic devices.
Primary Outcome Measures
NameTimeMethod
Rate of patients with intraoperative adverse eventsDuring surgery

events other than the normal course of the surgery

Mean of retrieved lymph nodesWithin 30 days after surgery

Count of retrieved lymph nodes at the histopathological examination of the surgical specimen

Rate of patients alive5 year after surgery

subjects alive at the planned endpoint

Secondary Outcome Measures
NameTimeMethod
Mean post-operative hospital stayfrom the day after surgery to patient discharge, assessed up to 90 days

hospital stay of the patients after surgery

Rate of complications after discharge5 year after surgery

any surgical related event after patient's discharge

Trial Locations

Locations (1)

Department of Digestive Surgery, St. Mary's Hospital, University of Perugia

🇮🇹

Terni, Italy

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