Clinical trial NCT04934982: Laparoscopic or Abdominal Radical Hysterectomy for Cervical Cancer(Stage IA1 With LVSI, IA2)
Official title: A Multicenter Noninferior Randomized Controlled Study Comparing the Efficacy of Laparoscopic Versus Abdominal Radical Hysterectomy for Cervical Cancer (Stage IA1 With LVSI, IA2)
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Cervical Cancer
Keywords: Cervical Cancer
Abdominal Radical Hysterectomy
Laparoscopic Radical Hysterectomy
Lead sponsor: Obstetrics & Gynecology Hospital of Fudan University
Sponsor class: OTHER
Collaborators: name: Children's Hospital of Fudan University
name: Xinhua Hospital, Shanghai Jiao Tong University School of Medicine
name: Shanghai Zhongshan Hospital
name: RenJi Hospital
name: Taizhou Hospital, Affiliated Cancer Hospital of the University of Chinese Academy of Sciences
name: First Affiliated Hospital of Wenzhou Medical University
First posted: 2021-06-22
Enrollment: 690
Sex: FEMALE
Minimum age (years): 21
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to confirm whether there is a difference between laparoscopic radical hysterectomy (LRH) and abdominal radical hysterectomy (ARH) in patient survival for Cervical Cancer (Stage IA1 with LVSI, IA2)

Detailed description: The purpose of this study is to compare LRH (or robotic-assisted) and ARH in patients with cervical cancer (Stage IA1 with LVSI, IA2), by a multicenter stratified randomized controlled study, mainly including the following aspects:

1. To compare the differences in PFS and OS between patients receiving LRH and ARH.
2. To investigate whether PFS and OS in LRH can be improved by more rigorous specification of surgical details (including tumor-free principles and standard surgical scopes).
3. To assess postoperative complications and quality of survival.

Eligibility criteria: Inclusion Criteria:

1. Clinical diagnosis of squamous carcinoma of the cervix, adenocarcinoma, squamous adenocarcinoma (IA1 with lymphovascular interstitial invasion, stage IA2).
2. Age ≥ 21 years and ≤ 70 years.
3. Surgery type B and C (refer to Q-M surgical staging)
4. Normal range of liver and kidney function and blood count (specific details below) Hemoglobin \> 60g/L Platelets \> 70\*109/L Leukocytes \> 3\*109/L Creatinine \< 50mg/dL Transaminase abnormal indicators ≤ 3 Maximum value of transaminases not exceeding 3 times the corresponding normal value.
5. No history of other malignancies.
6. Non-pregnancy.
7. Physical strength classification: Karnofsky score ≥ 60;
8. Subjects voluntarily joined the study, signed the informed consent form, were compliant and cooperated with the follow-up.
9. No psychiatric disorders and other serious immune system disorders (e.g. lupus erythematosus, myasthenia gravis, HIV infection, etc.) (Note: Maximum diameter measurement of cervical lesions is based on PET-CT, or CT, or MRI)

Exclusion Criteria:

1. Those who are contraindicated for various surgeries and cannot undergo surgery.
2. Patients who have received pelvic/abdominal radiotherapy irradiation or neoadjuvant chemotherapy for cervical cancer.
3. Patients with recurrent cervical cancer
4. Patients with CT, MRI or PET-CT suggesting suspicious metastasis of pelvic lymph nodes with maximum diameter \>2cm after further improvement of preoperative examination.

Primary outcomes:
measure: the rate of PFS at 5 years
timeFrame: 5 years from surgery
Secondary outcomes:
measure: the rate of OS at 5 years
timeFrame: 5 years from surgery
Other outcomes:
measure: Analysis of continuous outcomes
timeFrame: 1 years from surgery
measure: Analysis of binary outcomes
timeFrame: 5 years from surgery
measure: Safety analysis
timeFrame: 5 years from surgery
Locations:
city: Shanghai
country: China
facility: The Obstetrics and Gynecology Hospital of Fudan University
Study officials:
affiliation: The Obstetrics and Gynecology Hospital of Fudan University
name: Hua Jiang, PHD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Wu X, Feng H, Gao S, Feng H, Diao W, Zhang H, Du M, Lou W, Wang X, Zhu T, Zhang Y, Hu W, Xue X, Zhu Z, Xiang L, Li J, Fang X, Bai Y, Hou Y, Yan W, Qiu L, Yu H, Zhu S, Du Y, Jiang H. A multicenter noninferior randomized controlled study comparing the efficacy of laparoscopic versus abdominal radical hysterectomy for cervical cancer (stage IA1 with LVSI, IA2): study protocol of the LAUNCH 1 trial. BMC Cancer. 2022 Apr 9;22(1):384. doi: 10.1186/s12885-022-09494-4.