Cancer of Colon Clinical Trial
Official title:
Evaluating the Association Between Psoas Density Measurement on Preoperative CT Imaging and Postoperative Outcomes
Colorectal cancer (CRC) is the 3rd most common cancer worldwide. In the UK, CRC is the 4th
most common cancer accounting for 12% of cancers diagnosed each year with approximately
41,300 new cases diagnosed in 2014. Surgery remains the only treatment option that can
reliably achieve cure from colorectal cancer and thus nearly 20,000 major bowel resections
are performed for this yearly in the UK. Surgery for these cancers however carries risk of
major complications and potentially death. Selecting appropriate patients for surgery remains
a challenge to cancer teams.
Risk factors exist for complications after surgery for CRC, many of which can be assessed and
discussed with the patient prior to surgery, so that any decision to operate is with fully
informed consent from the patient. Increasing attention is being paid to a patient's frailty
or fitness as one of these risk factors. Our centre has previously shown that measuring the
cross-sectional area of the psoas muscle (a large muscle near the spine) from preoperative
imaging could predict major complications in colorectal cancer patients (Jones 2015), however
specialist software and patient height is required to make this calculation. More recently we
have demonstrated that the measurement of the psoas muscle density on preoperative imaging
(i.e. routine CT scans that all patients have before surgery to plan treatment), may
potentially be useful to predict which patients are at most risk of a major complication
(Herrod 2019). If this finding holds true when tested on a larger scale, it could be used to
help surgical teams make the decision on whether to offer surgical resection, what kind of
operations to perform, how to best support individuals undergoing operation and to ensure
that the patient has the most information available to decide what risk they are at by having
major surgery.
Status | Not yet recruiting |
Enrollment | 1000 |
Est. completion date | December 1, 2020 |
Est. primary completion date | July 1, 2020 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: Patient criteria: - Having a major colorectal resection for the treatment of cancer - Elective or emergency surgery - Adults, defined as age =18 years of age (no maximum limit) - Had a preoperative CT scan of the abdomen with contrast (portal venous phase) - Operation performed between 31st Aug 2013 - 31st Aug 2019 Exclusion Criteria: - Not having a preoperative CT scan with contrast |
Country | Name | City | State |
---|---|---|---|
United Kingdom | School of Graduate Entry Medicine, Royal Derby Hospital | Derby | Derbyshire |
Lead Sponsor | Collaborator |
---|---|
University of Nottingham |
United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Number of post operative complications (Clavien-Dindo grade 3-4) during inpatient hospital stay. | Recorded post operative complications requiring intervention during post operative stay until initial discharge from hospital. | Through study completion, an average of 10 days. | |
Secondary | Post operative length of stay | Number of days | Through study completion, usually between 6-10 days. | |
Secondary | Mortality | Recorded patient death | Up to 5 year follow up from operation | |
Secondary | Post operative complications beyond hospital discharge. | Recorded post operative complications (including re-operation or recurrence) until discharge from surgical clinic or date of record review. | From hospital discharge to record review (i.e. 30 days, 90 days, 2 - 5 year follow up). |
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