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Open Versus Laparoscopically-assisted Esophagectomy for Cancer

Not Applicable
Completed
Conditions
Esophageal Cancer
Registration Number
NCT00937456
Lead Sponsor
University Hospital, Lille
Brief Summary

To compare laparoscopically-assisted gastric mobilization versus open gastric mobilization in Ivor-Lewis esophagectomy for esophageal cancer, with open thoracic approach in the 2 arms.

Detailed Description

Open Versus Laparoscopically-assisted Esophagectomy for Cancer

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
207
Inclusion Criteria
  • Squamous cell or adenocarcinoma of the thoracic esophagus T1, T2, T3, N0-N1, M0, before any treatment
  • Middle or lower third esophageal carcinoma, junctional tumor Siewert type I
  • Patients who underwent or not neoadjuvant chemotherapy or chemoradiation
  • Tumor deemed to be resectable in a curative intent at the preoperative setting
  • Age less than 75 years old, OMS status 0, 1 or 2
  • Patient who can undergo one or the other surgical modality
  • Written informed consent form
  • Possible follow-up
Exclusion Criteria
  1. General criteria: PO2 ≤ 60 mmHg; PCO2 > 45 mmHg; FEV ≤ 1000 ml/sec

    • Hepatic cirrhosis
    • Recent myocardial infarction (in the previous 6 months) or progressive coronary disease
    • Distal arteritis (Leriche-Fontaine stage II upwards)
    • Concomitant cancer, other than subcarinal esophageal cancer
  2. Disease-related factors

    • Invasion of subclavicular lymph nodes in a clinical examination or on biospy
    • Lymph nodes near the origin of the celiac artery with a diameter ≥ 1 cm on CT or that appear to be suspect on endoscopic ultrasound (to differentiate them from the paracardial or left gastric lymph nodes, which does not constitute an exclusion criterion)
    • Recurrent nerve palsy
    • Evidence of extension to the tracheobronchial tree
    • Signs of mediastinal invasion (vertebral contact, aortic contact ≥ 90°, or invasion of nonresectable neighboring organs such as the aorta, trachea, main bronchi, etc.)
    • Distant metastasis
  3. Laparoscopy-related factors

    • Patient presenting a general contraindication to laparoscopy
    • A history of median or subcostal laparotomy

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
To decrease postoperative major 30-days morbidity from 45% in the open arm to 25% in the laparoscopically-assisted arm.30 days
Secondary Outcome Measures
NameTimeMethod
disease free survival2 years
economical interest of the surgical technique apprehended through a hospital point of view6 months
overall morbidity30 days
overall survival2 years
quality of life2 years

Trial Locations

Locations (11)

Hopital Du Haut Leveque

🇫🇷

Bordeaux, France

Hopital Ambroise Pare Ap-Hp

🇫🇷

Boulogne Billancourt, France

Hotel Dieu

🇫🇷

Clermont Ferrand, France

Hopital Louis Mourier

🇫🇷

Colombes, France

Hopital de La Croix Rousse

🇫🇷

Lyon, France

Hopital St Marguerite Ap-Hm

🇫🇷

Marseille, France

Hopital St Louis Ap-Hp

🇫🇷

Paris, France

Institut Mutualiste Montsouris

🇫🇷

Paris, France

Hopitalpontchaillou

🇫🇷

Rennes, France

Hopitaux Universitaires de Strasbourg

🇫🇷

Strasbourg, France

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Hopital Du Haut Leveque
🇫🇷Bordeaux, France

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