Endometrial Cancer Clinical Trial
Official title:
Appropriateness Evaluation of Follow up Procedures in Gynaecology Oncology TOTEM Study: Multicentric Randomized Controlled Clinical Trial Between Two Follow up Regimens With Different Tests Intensity in Endometrial Cancer Treated Patients.
This study aims to compare two different follow up regimens with different test intensity in
endometrial cancer treated patients.
If eligibility criteria are satisfied and the written informed consensus is obtained,
patients are stratified inside the centre according to their risk level:
- Group 1 : patients at low risk of recurrence [stage IA G1 and stage IA G2]
- Group 2 : patients at high-risk of recurrence [≥ stage IA G3] (Ethics Committee
amendment of 14th September 2010, use new 2010 FIGO classification for endometrial
cancer!)
In each group patients will be randomized in two regimens of follow up:
1. Minimalist (Arm 1)
2. Intensive (Arm 2)
Features of each arm are listed in "Arms" item.
The procedure for centralized randomization, with blocks of variable length, will take place
within each layer with 1:1 ratio and will be implemented within the centralized database,
with sequences generated by dedicated software. The recruitment and randomization has to be
registered on the website (www.epiclin.cpo.it) no later than 20 days after histological
examination has been received. If patients do not need any kind of adjuvant therapy they will
start follow-up program according to the regimen chosen for them at randomization, if
adjuvant therapy is needed the patient at first will be registered and the randomization will
be deferred at the end of treatment.
In presence of symptoms or signs detected during the clinical visit which may suppose a
recurrence or in presence of abnormal tests, the clinician has to prescribe all medical tests
and examinations required. The tests carried out in addition to follow-up scheduled program
must be reported in the database. Nevertheless patients continue to be followed for the
assessment of the performance status at 5 years, but the follow-up schedule is up to the
clinician. An interim analysis is scheduled in 3.5 years starting from the beginning of
recruitment (based on approximately 1 / 3 of the total expected events, when about 4 / 5
cases have already been enrolled). Patients will be stratified by recruitment Center, by
level of risk (calculated according to the stage of the disease, the histotype and the
grading) and by type of treatment performed.
The focus of the study is to:
- Compare the effect of two FU regimens on 5-years OS
- Evaluate the difference in diagnosis anticipation
- Evaluate the difference in terms of recurrences
- Describe the compliance and QoL of patients
- Evaluate the cost-effectiveness and the cost-utility
;
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