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Ileocecal resection with extended D3 lymphadenectomy.

Right hemicolectomy with D3 lymphadenectomy

Laparoscopy ileocecal resectionith extended D3 lymphadenectomy including 201, 202, 203 and 213 groups of lymph nodes. Manual double-row ileo-ascendo-anastomosis.

ileocecal resection with extended D3 lymphadenectomy.

Laparoscopy right hemicolectomy with D3 lymphadenectomy including 201, 202, 203, 213, 211, 212, 221, 222-rt groups of lymph nodes. Manual double-row ileo-transverse-anastomosis.

Right hemicolectomy with D3 lymphadenectomy.

Igor Matveev

Mikhail Danilov

The purpose of this study is to determine the clinical efficacy, safety, and oncologic outcomes of ileocecal resection (ICR) with D3 lymphadenectomy compared to standard right hemicolectomy(RHC) for cecal cancer.

The design involves random allocation of eligible patients to ICR or RHC group in 1:1 ratio.

Requirements applied to centers participating in the trial and surgeons performing procedures are described in the protocol and refer to center volume and surgeon's experience.

Regular quality control includes the requirement to photograph the surgical specimen with a mark to determine the extent of lymphadenectomy performed and the number of the lymph node group.

After surgery patients are treated according to local standards, regardless of whether ICR or RHC was performed. Short-term and long-term outcomes are recorded according to the protocol.

Intervention. In all cases the tumor is localized in the area of the cecum; the border of the transition to the ascending colon is the upper lip of the ileocecal valve. The patient is not included in the study if the preoperative stage of examination reveals: synchronous cancer, distant metastasis (M1), locally advanced nature of the primary tumor (cT \> 3).

All patients will be randomly divided into two groups in a 1:1 ratio.

1. Research group (ICR) - Laparoscopy ileocecal resection with extended D3 lymphadenectomy (including 201, 202, 203 and 213 groups of lymph nodes). The minimum distance from the tumor is 10 cm, along the line of adequate blood supply. Next step - formation of a manual double-row ileo-ascendo-anastomosis.
2. Control group (RHC) - Laparoscopy right hemicolectomy with D3 lymphadenectomy (including 211, 212, 221, 222-rt groups of lymph nodes). Next step - formation of a manual double-row ileo-transverse-anastomosis.

Expected Results. The ICR will improve the short-term results of treatment of patients with cecal cancer compared with the standard RHC technique without affecting long-term results.

All patients will be randomly divided into two groups in a 1:1 ratio.

1. Research group (ICR) - Laparoscopy ileocecal resection with extended D3 lymphadenectomy (including 201, 202, 203 and 213 groups of lymph nodes). The minimum distance from the tumor is 10 cm, along the line of adequate blood supply. Next step - formation of a manual double-row ileo-ascendo-anastomosis.
2. Control group (RHC) - Laparoscopy right hemicolectomy with D3 lymphadenectomy (including 211, 212, 221, 222-rt groups of lymph nodes). Next step - formation of a manual double-row ileo-transverse-anastomosis.

Local Cecal Cancer - Optimization of Surgical Treatment

Study of the Oncological Outcomes of Ileocecal Resection With D3 for Cecal Cancer

We are not planning to share personal patient data.

X-ray assessment (Node-RADS classification) of clinical stage (N0 or N+) and distribution of suspicious lymph nodes into groups.

Questionnaires by European Organization for Research and Treatment of Cancer. EORTC QLQ - CR29.

Survival without local or distant recurrence.

Number of removed lymph nodes according to pathomorphological evaluation.

The ratio of affected lymph nodes into groups (201, 202, 203, 213, 211, 212, 221 or 222-rt) depending on the type of surgical treatment. Based on pathological assessment.

Average length of removed bowel in both groups according to pathomorphological evaluation (millimeters).

Average area of the removed mesentery in each groups according to pathomorphological evaluation (square centimetre - sq.cm).

Average blood loss during surgery in each group (ml).

Average operation time for each group (minutes - min).

The total number of conversions for each group.

Average number of days of inpatient treatment.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Local Cecal Cancer - Optimization of Surgical Treatment	NCT06121089	Colonic Neoplas... Cecal Neoplasms	ileocecal resec... Right hemicolec...	18 Years -	Moscow Clinical Scientific Center
Local Cecal Cancer - Optimization of Surgical Treatment	NCT06121089	Colonic Neoplas... Cecal Neoplasms	ileocecal resec... Right hemicolec...	18 Years -	Moscow Clinical Scientific Center

Spots Global Cancer Trial Database for ileocecal resection