Breast Cancer Patients in Stage 0-3A in Preoperative Evaluation Clinical Trial
— ROMOfficial title:
A Prospective Multicenter Randomized Clinical Trial: Robot-assisted vs. Open Nipple-sparing Mastectomy With Immediate Breast Reconstruction (ROM) Trial
NCT number | NCT05490433 |
Other study ID # | 4-2022-0600 |
Secondary ID | |
Status | Recruiting |
Phase | N/A |
First received | |
Last updated | |
Start date | October 26, 2022 |
Est. completion date | June 2030 |
the purpose of the study: It provides the highest level of evidence ever studied on the use of robotic surgical systems during breast surgery for breast cancer treatment, and aims to reveal the clinical significance of successive breast reconstruction(immediate breast reconstruction, IBR) at the same time as Robot-assisted nipple-sparing mastectomy (RNSM)
Status | Recruiting |
Enrollment | 790 |
Est. completion date | June 2030 |
Est. primary completion date | June 2030 |
Accepts healthy volunteers | No |
Gender | Female |
Age group | 19 Years to 70 Years |
Eligibility | Inclusion Criteria: - Adult women over the age of 19 with breast cancer scheduled for therapeutic mastectomy and who want immediate reconstruction - Stage 0-III breast cancer at initial evaluations - ECOG performance status of 0 or 1 Exclusion Criteria: - Patients planned for breast-conserving surgery or who are not candidates for IBR are excluded. - Clinical evidence for nipple or skin involvement of tumors in preoperative evaluations - A pregnant or lactating woman - Only tumors with lobular carcinoma in situ - Mammary Paget's disease - Inflammatory breast cancer - Male breast cancer - Stage IIIB-IV disease at initial presentation - Women with breast Cup E or higher - Previous history of breast cancer (metachronous breast cancer) - Previous history of non-mammary malignant disease excluding non-melanoma skin cancer or thyroid papillary/follicular cancer - Special type cancer (phyllodes tumor, sarcoma, and lymphoma) - Age > 70 - ASA, grade 4 or higher - Patients who do not have the ability to give informed consent - Previous thoracic radiation history - Patients who have not been tested for hepatitis before surgery (HBV, HCV) and HIV (compensation insurance policy) |
Country | Name | City | State |
---|---|---|---|
Korea, Republic of | Samsung Changwon Medical Center | Changwon | |
Korea, Republic of | Keimyung University Dongsan Hospital | Daegu | |
Korea, Republic of | Kyungpook National University Chilgok Hospital | Daegu | |
Korea, Republic of | Myongji Hospital | Goyang-si | |
Korea, Republic of | The Catholic University of Korea, Incheon ST. Mary's Hospital | Incheon | |
Korea, Republic of | Kosin University Gospel Hospital | Pusan | |
Korea, Republic of | Chungnam National University Sejong Hospital | Sejong | |
Korea, Republic of | Asan Medical Center | Seoul | |
Korea, Republic of | Gangnam Severance Hospital | Seoul | |
Korea, Republic of | Korea University Anam Hospital | Seoul | |
Korea, Republic of | Samsung Medical Center | Seoul | |
Korea, Republic of | Seoul National University Hospital | Seoul | |
Korea, Republic of | Yonsei University Health System, Severance Hospital | Seoul | |
Korea, Republic of | Yongin Severance Hospital | Yongin-si |
Lead Sponsor | Collaborator |
---|---|
Yonsei University |
Korea, Republic of,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | 5-year disease-free survival rate(DFS) | Events of disease-free survival (DFS) include local outbreaks, local recurrence, remote recurrence, opposite breast cancer and all-cause mortality. Local relapses include recurrence of the east breast or chest muscles, recurrence of the east chest wall, and recurrence of the east axillary lymph nodes, recurrence of the east subclavicular/clavicular lymph nodes, and recurrence of the east internal mammary lymph nodes. Events of local recurrence and opposite breast cancer include intraepithelial carcinoma. Using the stratification factor(proportional hazards models: organ and staging), find the Hazard ratio and the 95% confidence interval. If the upper limit of the confidence interval is less than the non-inferior limit, it is evaluated as non-inferior. |
The DFS period is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Five-year overall survival (OS) rates | Event of OS is death with any cause. OS time is calculated using months between the operation date to the event date. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Five-year breast cancer-specific survival (BCSS) rates | Event of BCSS only includes death related to breast cancer. Death related to causes other than breast cancer is censored | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Five-year distant recurrence-free survival (DRFS) rates | Event of DRFS includes distant recurrence as the first event. Locoregional recurrence and contra-lateral breast cancer are censored. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Five-year locoregional recurrence-free survival (LRFS) rates | Event of LRFS includes local recurrence and regional recurrence as the first event. Distant recurrence and contra-lateral breast cancer are censored. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Five-year nipple recurrence (NR) rates | Event of NR only includes recurrence in the NAC as the first event. Ipsilateral in-breast or pectoralis muscle recurrence, ipsilateral chest wall recurrence, ipsilateral regional recurrence, contralateral breast cancer, and distant recurrence are censored. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Margin positive rates | Turmo involvement of NAC, superficial, posterior, or circumferential margins, which is confirmed in final permanent pathology after the definitive surgery, are considered to be margin positive. Margin positive rates will be analyzed. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Open conversion rate (RNSM arm only) | Open conversion of RNSM to CNSM during surgery in the RNSM group is analyzed. The reason of open conversion is documented. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Operation time | Total operation time including mastectomy and reconstruction time. Each operation time will be collected. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Postoperative complication rates in postoperative 30 days | Postoperative complication rates are calculated as a total number of occurences of postoperative complications per total patients in each group. Number of postoperative complications per person is also assessed. Number of postoperative complication ? grade III per person is measured. NAC necrosis rates will be analyzed. Estimation of postoperative complications rates in 30 days With a sample size of 790 (710 excluding 10% loss of follow up), it has at least 80% power to detect various assumptions of complication rates with a non-inferiority margin of 7.5% between the open and robotic arms. The 30-day complication rate for the open arm is assumed to be between 25-50% , the corresponding maximum 30-day complication rates for the robotic arm to conclude non-inferiority are provided in table 6. These will be analyzed as secondary endpoints. |
secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Clavien-Dindo grade of postoperative complications in postoperative 180 days | Clavien-Dindo grade of postoperative complications is evaluated. Postoperative complication ? grade III including flap or implant loss are assessed for the analysis. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Implant or graft (flap) loss rates within 1 year from surgery | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | ||
Secondary | Patient reported outcomes in postoperative 3 - 12 months from the definitive surgery (patient satisfaction) | Mastectomy Module Pre-and Postoperative Scales Satisfaction with Breasts assessed by BREAST-Q version 2.0. Higher scores reflect a better outcome. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Surgeon's satisfaction in postoperative 3 month to 1 year | Satisfaction of surgery assessed by Surgeon(s) Overall symmetry, postoperative scar, and NAC symmetry are measured using scoring system 0-10. The higher scores are, the better an outcome is. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) | |
Secondary | Cost-effectiveness in postoperative 3 month to 1 year | Cost-effectiveness evaluation according to the surgical method, by conducting a questionnaire survey on the subject 6 months to 1 year after the last surgery. Evaluation follows the EuroQol five-dimension scale (EQ5D) Korean version questionnaire. In all scales, higher scores reflect a better outcome. | secondary outcome is calculated from the date of surgery to the time the first event occurs, or if the event is not reported on the last follow-up date.(After 5 years of follow-up observation of subject registration) |