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Preoperative Intravenous Iron Therapy in Patients With Gastric Cancer

Phase 4
Not yet recruiting
Conditions
Anemia
Surgery
Gastric Cancer
Iron Deficiency Anemia
Surgery--Complications
Interventions
Registration Number
NCT04168346
Lead Sponsor
Helsinki University Central Hospital
Brief Summary

The main objective of this investigator initiated study is to study if preoperative intravenous iron is effective in reducing need for allogenic blood transfusion in patients with gastric cancer who will undergo a standardized gastrectomy including both total and subtotal gastrectomies. The hypothesis is that intravenous iron reduces the need for perioperative blood transfusions.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
202
Inclusion Criteria
  • Patients with gastric cancer who will undergo a gastrectomy
Exclusion Criteria
  • Patients under 18 years old
  • Patients not in full understanding
  • Hemoglobin levels > 155 g/l for women and >167 g/l for men (upper reference limits for the laboratory of Helsinki University Hospital district) preoperatively.
  • Transferrin saturation level >50%
  • Emergency gastrectomy
  • Palliative gastrectomy
  • Acute bacterial infection
  • Known hypersensitivity to the active substance, to ferric carboxymaltose or any of its excipients, or to other parental iron products
  • Clinical evidence of iron overload or disturbances in the utilisation of iron
  • Patients <35 kg
  • Dialysis therapy for chronic renal failure
  • Hemochromatosis
  • Polycythemia vera
  • Pregnancy
  • Patients in need of direct blood transfusion ( Criteria for this are hemoglobin < 80 g/l or < 90 g/l if the patient is symptomatic or has a history of heart disease)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlacebosPlacebo is NaCl 0.9% solution, which is administrated in the same way as the study drug
InterventionFerric carboxymaltoseIV-iron substitution: The intravenous iron formulation used in the study is ferric carboxymaltose and it will be administered two to four weeks before the surgery, aiming at four weeks. The dose of intravenous iron will be calculated according to the weight and haemoglobin level of the patients, however so that all the patients receive minimum 1000mg iv iron and the maximum dose is 20 mg/kg per day.
Primary Outcome Measures
NameTimeMethod
The need for blood transfusionWithin 30 days from the day of the operation

Number of patients needing transfusions

Secondary Outcome Measures
NameTimeMethod
Postoperative complicationsWithin 30 days from operation

Postoperative complications measured using Comprehensive complication index

90-day mortalityWithin 90 days from operation

90-day mortality

Overall survival1, 3 and 5 years from operation

Overall survival

Length of hospital stayWithin hospital stay, on average 7 - 14 days

Length of hospital stay

Use of IV iron after operationWithin 3 months from operation

Number of doses and median dose of IV iron

Patients' quality of life (15D)One and six months after the surgery

15D questionnaires

Patients' quality of life (EQ-5D)One and six months after the surgery

EQ-5D questionnaires

Patients' quality of life (FRAIL)One and six months after the surgery

FRAIL questionnaires

Patients' quality of life (PRISMA-7)One and six months after the surgery

PRISMA-7 questionnaires

Re-admission30 days after discharge from hospital

Patient re-admission rates

Patients' quality of life (RAND)One and six months after the surgery

RAND questionnaires

Patients' haemoglobin and iron parameter levelsThree months after the surgery

Patients' haemoglobin and iron parameter levels

Patients' quality of life (GSRS)One and six months after the surgery

GSRS questionnaires

Patients' quality of life (IDQ)One and six months after the surgery

IDQ questionnaires

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