Esophageal Cancer Clinical Trial
Official title:
Adjuvant Esophagectomy Versus Chemoradiation for Patients With Clinical Stage N0 and Pathological Stage T1b (After Endoscopic Submucosal Dissection, ESD) Esophageal Squamous Cell Carcinoma (Ad-ESD Trial): a Multicentric, Open Label, Randomized Trial
The ad-ESD trial is phase III randomized trial to compare adjuvant esophagectomy and chemoradiation for patients with clinical stage N0 and pathological stage T1b squamous cell carcinoma (after endoscopic submucosal dissection).
Esophagectomy is still the primary treatment for pathological T1b esophageal squamous cell
carcinoma. However, esophagectomy is associated with high mortality and morbidity and
decreased quality of life. Endoscopic resection followed with chemoradiation had showed
uncompromised oncological outcomes with esophagectomy. But there is no well-designed, phase
III trial to compare the two treatment for patients with pT1b squamous cell carcinoma.
The ad-ESD trial is a multi-center prospective superiority trial, combied of a randomized
clinical trial and a prospective registry.
The experimental design produces two randomized arms; (1) esophagectomy and (2)
chemoradiation. An additional registry arm will be based on surgeons/patients that do not
want to be randomised because of their own experience on adjuvant therapy, including
esophagectomy; chemoradiation and active surveillance.
The primary endpoint is to evaluate the difference of 5-year overall survival rate between
definitive chemoradiation and esophagectomy, in patients with cN0-pT1b esophageal squamous
cell cancer (ESCC) after endoscopic resection.
The secondary endpoints are to evaluate the difference of quality of life and oncological
outcomes including 3-year overall survival (OS) and 3, 5-year relapse free survival (RFS)
between the two treatments.
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