Chemotherapy Followed by Surgery versus Surgery Alone in Patients with Oesophageal Squamous Cell Carcinoma

ISRCTN ISRCTN54829649
DOI https://doi.org/10.1186/ISRCTN54829649
Secondary identifying numbers N/A
Submission date
23/08/2010
Registration date
25/10/2010
Last edited
05/08/2021
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Cancer
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Jurjen Boonstra
Scientific

Dr Molewaterplein 50
Rotterdam
3000 CA
Netherlands

Study information

Study designMulticentre randomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use contact details below to request a patient information sheet
Scientific titleChemotherapy Followed by Surgery versus Surgery Alone in Patients with Oesophageal Squamous Cell Carcinoma: Long-term Results of a Randomised Controlled Trial
Study objectivesPatients with oesophageal sqaumous cell carcinoma who receive preoperative chemotherapy have equal or better overall survival compared to patients who undergo surgery alone
Ethics approval(s)The study protocol was approved by the Ethics Committee of all participating institutions, and by the Review Board of the Netherlands Cancer Foundation
Health condition(s) or problem(s) studiedOesophageal squamous cell carcinoma
InterventionRandom assignment was stratified by age, gender, weight loss in the past four months and length of the tumor as measured by esophago-gastroscopy.
Patients assigned to preoperative chemotherapy (CS group) received neoadjuvant etoposide plus cisplatin. Cisplatin, at a dose of 80 mg/m2, was given intravenously over 4 hours on day one of each cycle preceded and followed by adequate hydration. Etoposide, at a dose of 100 mg/m2, was administered intravenously over 2 hours on day 1 (before cisplatin) and day 2, followed by etoposide 200 mg/m2 orally on days 3 and 5. This course was repeated in week 4. In case of clinical response, two subsequent courses of chemotherapy were administered in week 8 and 11. Surgery was performed between 4 and 6 weeks after the last course of chemotherapy.

Patients assigned to surgery alone (S group) recieved surgery as soon as possible.

Surgery protocol for both treatment groups:
For carcinomas of the upper half of the intra-thoracic esophagus a right-sided thoracotomy was performed. For carcinomas of the lower half of the intra-thoracic esophagus a transhiatal esophagectomy was preferred. The tumor and its adjacent lymph nodes were dissected en bloc. The left gastric artery was transected at its origin, with resection of local lymph nodes. The continuity of the digestive tract was restored by means of gastric tube reconstruction or colonic interposition with a cervical anastomosis.
Intervention typeOther
Primary outcome measureOverall survival
Secondary outcome measuresDisease free survival
Overall study start date01/01/1989
Completion date01/01/1996

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants160
Total final enrolment169
Key inclusion criteria1. Histologically confirmed squamous cell carcinoma of the intra-thoracic oesophagus
2. No evidence of distant metastases
3. Absence of unresectable local disease
4. Below 80 years of age
5. In adequate physical condition (Karnofsky score >70) to undergo surgery
6. Adequate hepatic, renal and bone marrow function
Key exclusion criteria1. Synchronous cancer
2. Tumour localization in the cervical oesophagus (upper border, <18 cm from the incisor teeth)
3. Severe cardiovascular or pulmonary disease
Patients with previous malignancies were eligible if more than 5 years had elapsed from diagnosis without evidence of tumor recurrence; exceptions were made for adequately treated basal cell cancer of the skin or carcinoma in situ of the cervix.
Date of first enrolment01/01/1989
Date of final enrolment01/01/1996

Locations

Countries of recruitment

  • Netherlands

Study participating centre

Dr Molewaterplein 50
Rotterdam
3000 CA
Netherlands

Sponsor information

Erasmus Medical Centre (Netherlands)
Hospital/treatment centre

Dr Molewaterplein 50
Rotterdam
3000 CA
Netherlands

ROR logo "ROR" https://ror.org/018906e22

Funders

Funder type

Hospital/treatment centre

Erasmus Medical Centre (Netherlands)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration

1997 results in Kok TC, van Lanschot JJB, Siersema PD, van Overhagen HV, Tilanus HW. Neoadjuvant chemotherapy in operable esophageal squamous cell cancer: final report of a phase III multicenter randomized controlled trial. Proc Am Soc Clin Oncol. 1997; 17:984.
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article 19/05/2011 05/08/2021 Yes No

Editorial Notes

05/08/2021: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
3. Details of abstract results have been added to the publication and dissemination plan.