Early Stage Endometrial Cancer Clinical Trial
Official title:
Upper Vaginectomy Versus Brachytherapy in Patients With Early Stage Endometrial Cancer Treated With Laparoscopic Surgery: a Randomized Controlled Study.
Recent findings have suggested that laparoscopic surgery is safe and effective, as well as
laparotomic one, for treating patients with early stage endometrial cancer (ESEC). Moreover,
our long-term previous data have shown a trend in vaginal cuff recurrence in subjects who
underwent laparoscopic approach to ESEC consisting of extrafascial hysterectomy, bilateral
salpingo-oophorectomy, pelvic +/- para-aortic nodes dissections, regardless grading or
lymphovascular space invasion.
Based on these considerations, the aim of the current protocol-study will be to compare two
different strategies for vaginal cuff recurrences prevention in patients affected by ESEC
treated with laparoscopic surgery. In particular, upper vaginectomy followed by observation
will be compared to post-operative brachytherapy.
Women with ESEC scheduled for laparoscopic surgery will be enrolled and randomized in three
arms [vaginectomy group (VG), brachytherapy group (BG), and control group (CG)]. All
laparoscopic procedures will consist of total hysterectomy, bilateral salpingo-oophorectomy,
peritoneal washing, systematic inspection of peritoneal cavity and biopsy of each suspect
lesion, and pelvic (and eventual para-aortic) lymphadenectomy. In VG an upper vaginecomy
will be added to standard laparoscopic procedures followed by observation, whereas BG will
receive post-operative brachytherapy. CG will be treated with standard protocol for
management of ESEC according to National Comprehensive Cancer Network (www.nccn.org).
Safety and efficacy data will be recorded in each group for 24 months of follow-up.
Data will be analyzed using the intention-to-treat principle and a P value of 0.05 or less
will be considered significant.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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