- To test the hypothesis that laparoscopic-assisted resection is not inferior to open resection, based on a composite primary endpoint of oncologic factors that are indicative of a safe and feasible surgical resection, in patients with stage IIA, IIIA, or IIIB rectal cancer.
- To compare the patient-related benefit of laparoscopic-assisted resection vs open resection, in terms of blood loss, length of stay, and utilization of pain medication.
- To compare the disease-free survival and local pelvic recurrence at 2 years.
- To compare the quality of life, sexual function, and bowel and stoma function.
OUTLINE: This is a multicenter study. Patients are stratified according to site of primary tumor (high vs middle vs low rectum), registering surgeon, and planned operative procedure (low anterior resection vs abdominal perineal resection). Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo open laparotomy and rectal resection.
- Arm II: Patients undergo laparoscopic-assisted rectal resection. Quality of life is assessed periodically using EORTC Quality of Life Questionnaires (EORTC QLQ-C30 and -CR38), the Linear Analog Self-Assessment (LASA), the Stoma Quality of Life Scale (SQOLS), and the Mayo Bowel Function Questionnaire (MBFQ).
After completion of study treatment, patients are followed periodically for up to 5 years.
- Histologically confirmed adenocarcinoma of the rectum (≤ 12 cm from the anal verge)
- T3, N0, M0 or T1-3, N1-2, M0 disease by pre-neoadjuvant therapy CT scans and pelvic MRI or transrectal ultrasound
- No T4 disease
- Must have completed neoadjuvant fluorouracil-based chemotherapy and/or radiotherapy within the past 4 weeks
- Capecitabine may have been substituted for fluorouracil
- ECOG performance status 0-2
- Body mass index ≤ 34
- Negative pregnancy test
- No evidence of conditions (e.g., multiple prior major laparotomies or severe adhesions) that would preclude use of a laparoscopic approach
- No systemic disease (e.g., cardiovascular, renal, or hepatic) that would preclude surgery
- No other severe incapacitating disease (i.e., ASA IV [severe systemic disease that is a constant threat to life] or ASA V [moribund and is not expected to survive without the operation])
- No other invasive pelvic malignancy (cervical, uterine, or rectal) within the past 5 years
- No history of psychiatric or addictive disorders or other conditions that, in the opinion of the investigator, would preclude the patient from meeting the study requirements
PRIOR CONCURRENT THERAPY:
- See Disease Characteristics
Last updated: 02/07/2013
NCT ID: NCT00726622