Endometrial Cancer Conservative Treatment (E.C.Co). A Multicentre Archive
- Conditions
- Endometrial Cancer
- Registration Number
- NCT04290299
- Lead Sponsor
- National Cancer Institute, Naples
- Brief Summary
Approximately one fourth of cases of endometrial cancer (EC) are diagnosed in premenopausal women, of whom approximately 40% wish to preserve their fertility. When arising in young women, EC usually presents with favorable prognostic features, as a focal, well differentiated endometrioid tumor, with minimal or absent myometrial invasion. This profile corresponds to the Type 1 EC, which correlates with the estrogen/progesterone receptor positive (ER+/PR+) pattern. On the other hand, these patients frequently present with clinical signs of a hyperestrogenism (chronic anovulation, infertility, obesity). Primary progestin therapy has been demonstrated to be effective in early well differentiated tumors and in poor operative candidates with response rates ranging from 58-100%.Currently, the therapeutic approach to an early stage EC consists of a staging laparotomy/laparoscopy, including a total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO), peritoneal washings, and lymphadenectomy (pelvic and aortic), depending on the pathological risk profile pre- and intraoperatively determined. Therefore, the current standard of surgical approach is preclusive of fertility.
The worldwide experience and data on conservative management of EC are, however, still limited. Most of reports based on cases retrospectively collected, harboring potential methodological bias, using different treatments and drugs, and with insufficient follow-up.
Some systematic reviews have been published in the last decade, trying to summarize the literature data. Therapeutic results seem to be promising with a regression rate of approximately 75% and relapse occurring in 25-40% of cases, with anecdotical reports of deaths of disease (DOD). The fertility outcome was, however, not satisfying with about 30% pregnancy rate in patients attempting to conceive, and an overall low rate of assisted reproductive techniques (ART) despite the subfertile clinical profile.Therefore, there is a need for a prospective, multicentre cooperative project able to systematically collect data from consecutive patients treated according to defined (not necessarily identical) protocols, concerning the oncological, as well as, the obstetrical outcomes. Moreover, this project could represent the "template" in which a pretreatment fertility counseling, psychological support, and definitive surgery are routinely included according to shared criteria.
- Detailed Description
PURPOSE The goal of this research project is to learn more about the safety of conservatively treating EC and about subsequent fertility outcome.
PROJECT TYPE Observational (patient archive) - The project runs within the framework of Gynecologic Cancer InterGroup (GCIG), thus, participating Centres must belong to one of the qualified National groups.
PROJECT DESIGN Observational model: Cohort
TIME PERSPECTIVE Prospective
ENDPOINT CLASSIFICATION Cancer (response, relapse) and fertility (pregnancy, delivery) outcomes
INTERVENTIONS Data collection
OUTCOME MEASURES Primary outcome measures
* Proportion of complete regression
* Duration of response
* Frequency and pattern of relapse
* Frequency of metachronous ovarian cancer
* Tumor-related deaths
Secondary outcome measures
* Treatment related morbidity
* Frequency of spontaneous pregnancies
* Frequency of pregnancies after ART
* Pattern of residual disease on definitive surgical specimens
REQUIREMENTS FOR PATIENT REGISTRATION
* Informed consent to personal data processing
* Existence of an IRB-approved local protocol that allows conservative treatment to be performed or statement that such treatment is considered as a standard (please note that such protocols should be shared with the database owner National Cancer Institute of Naples).
TREATMENT Since this is a archive, treatment is not dictated by a protocol. However, treatment has to be administered according to a IRB-approved local protocol (except for the countries where conservative treatment can be given outside a IRB-approved study because considered as a standard procedure).
DURATION A first phase of three years is planned, eventually followed by further three years.
PUBLICATION POLICY Data generated are property of all investigators and will be object of publication after general agreement.
DATA TO BE COLLECTED
Patient enrollment and registration of data are made by appropriate eCRFs via the Clinical Trials Unit of National Cancer Institute of Naples (Study Data Center) website through the following steps:
1. go to http://www.usc-intnapoli.net;
2. select language;
3. click "Ask for authorization" to create your personal account;
4. fill and send the "authorization form";
5. make a screenshot of the "authorization form" and send it to l.sparavigna@istitutotumori.na.it;
6. enter into to the system using your credentials and click on "E.C.Co.";
7. click "the join request form";
8. wait for authorization (a verification message will be sent to your email address within 24-48 h);
9. enter into to the system using your credentials and click on "E.C.Co." for patient registration and/or updating.
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- Female
- Target Recruitment
- 100
- Informed consent to personal data processing
- Existence of an IRB-approved local protocol that allows conservative treatment to be performed or statement that such treatment is considered as a standard (please note that such protocols should be shared with the database owner National Cancer Institute of Naples).
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method Frequency of metachronous ovarian cancer 10 years Pattern of relapse 10 years Tumor-related deaths 10 years Frequency of relapse 10 years Proportion of complete regression 10 years Duration of response 10 years
- Secondary Outcome Measures
Name Time Method Treatment related morbidity 10 years Frequency of spontaneous pregnancies 10 years Frequency of pregnancies after ART 10 years Frequency of residual disease on definitive surgical specimens 10 years
Trial Locations
- Locations (19)
GOTIC - Gynecologic Oncology Trial and Investigation Consortium
🇯🇵Katō, Japan
EORTC - European Organization for Research and Treatment of Cancer
🇧🇪Brussels, Belgium
DGOG - Dutch Gynecologic Oncology Group
🇳🇱Amsterdam, Netherlands
PMHC (Princess Margaret Hospital Consortium)
🇨🇦Toronto, Canada
SGOG (Shanghai Gynecologic Oncology Group)
🇨🇳Shangai, China
GINECO - Group d'Investigateurs Nationaux pour l'Etude des Cancers Ovariens
🇫🇷Paris, France
AGO-De Arbeitsgemeinschaft Gynaekologische Onkologie Studiengruppe Ovarialkarzinom
🇩🇪Berlin, Germany
NCIC Clinical Trials Group (Canadian Cancer Society Research Institute)
🇨🇦Ottawa, Canada
AGO-AUST Arbeitsgemeinschaft Gynaekologische Onkologie
🇦🇹Vienna, Austria
KGOG - Korean Gynecologic Oncology Group
🇰🇷Seul, Korea, Republic of
NSGO (Nordic Society of Gynecologic Oncology)
🇩🇰Copenhagen, Denmark
MITO (Multicenter Italian Trials in Ovarian cancer and gynecologic malignancies)
🇮🇹Naples, Italy
ICORG - Ireland Cooperative Oncology Research Group
🇮🇪Dublin, Ireland
GEICO - Grupo Espanol de Investigacion en Cancer de Ovario
🇪🇸Madrid, Spain
JGOG - Japanese Gynecologic Oncology Group
🇯🇵Tokyo, Japan
SGCTG (Scottish Gynaecological Cancer Trials Group)
🇬🇧Edinburgh, United Kingdom
ANZGOG - Australia and New Zealand Gynecological Oncology Group
🇦🇺Sydney, Australia
Cooperative Ovarian Cancer Group (COGI)
🇺🇸Stanford, California, United States
NOGGO (Nord-Ostdeutsche Gesellschaft für Gynäkologische Onkologie)
🇩🇪Berlin, Germany