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the group underwent laparoscopic right hemicolectomy with CME. In complete mesocolic excision group (CME), the dissecting extent includes the lymphatic and fat tissues surrounding the root of ascending mesocolon, which situated on the surface of superior mesenteric vein, and the root of right half of transverse mesocolon, which situated on the surface of pancreas neck.

the group underwent laparoscopic right hemicolectomy with D3 lymph node dissection. In D3 lymph node dissection group(D3), the lymph node dissection is based on ligating the supplying vessels close to the right-side of superior mesenteric vein and clean up the surrounding lymph node and adipose tissue. No.6 lymph node should be dissected in this group.

the group underwent laparoscopic right hemicolectomy with CME. In CME group, in addition to D2 dissection, the whole mesocolon, from ascending colon to right half transverse colon, as well as the central lymph nodes should be entirely removed.

Intervention: Procedure: Complete mesocolic excision (CME)

the group underwent laparoscopic right hemicolectomy with D3 lymph node dissection. In D3 group, the mesocolon should be removed and the dissection involves the paracolon and intermediate lymph nodes,including No.6 lymph node, which along the feeding vessels.

Intervention: Procedure: D3 radical operation

Minhua Zheng, PhD

Hiju Hong, PhD Student

To standardize the surgery for advanced right hemi colon cancer with laparoscopy and investigate whether extended lymphadenectomy (CME) could improve disease-free survival in patients with right colon cancer, compared with D3 radical operation in laparoscopic colectomy.

Standardization of Laparoscopic Surgery for Right Hemi Colon Cancer (SLRC)

Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine

RenJi Hospital

Xinhua Hospital, Shanghai Jiao Tong University School of Medicine

Fudan University

Ruijin Hospital

professor

Liver Neoplasms

Neoplastic Processes

Liver Diseases

Micronutrients

Bone Density Conservation Agents

Hematinics

Vitamins

Vitamin D

Cholecalciferol

Calcium

Liver Extracts

Calcium, Dietary

Ergocalciferols

Trace Elements

Hormones

Vitamin D3

Calciferol

Ergocalciferol

Vitamin D2

One capsule of vitamin D3 10,000 IU orally once daily for 14 days until the date of surgery. To allow for some flexibility in the scheduling of surgery, patients can be treated with preoperative vitamin D3 for up to 28 days. On the morning of surgery, prior to operating, a second blood sample will be collected for follow-up 25(OH)D, calcium, and albumin determination. Colon and liver resection will occur per institutional standards of care, and malignant and adjacent benign tissue will be collected for the laboratory endpoints described in this protocol.

One placebo capsule orally once daily for 14 days until the date of surgery. To allow for some flexibility in the scheduling of surgery, patients can be treated with preoperative placebo for up to 28 days. On the morning of surgery, prior to operating, a second blood sample will be collected for follow-up 25(OH)D, calcium, and albumin determination. Colon and liver resection will occur per institutional standards of care, and malignant and adjacent benign tissue will be collected for the laboratory endpoints described in this protocol.

Take five 10,000 IU capsules (total 50,000 IU) once daily for 7 days, followed by one 10,000 IU capsule once daily until surgery.

Take five placebo capsules once daily for 7 days, followed by one placebo capsule once daily until surgery.

Placebo

Kimmie Ng, MD

Kimmie Ng, MD, MPH

This study seeks to learn more about the vitamin D receptor and its relationship to colon cancer. The Vitamin D receptor is found in colon cancer cells. When Vitamin D binds to the receptor in the cancer cells, it may stop cancer cells from growing abnormally and may cause cancer cell death. Vitamin D has been used in other research studies and information from those other research studies suggests that Vitamin D may help in the treatment of colon cancer.

Participants will receive either high-dose vitamin D or standard-dose vitamin D. The study drug will be given 14-28 days prior to your surgery. The number of days will depend on when the surgery is scheduled.

The participant will be given a study drug-dosing diary to keep track of when they take the study drug. The participant will be taking the study drug once every day, for 14 - 28 days, prior to their surgery.

* Run-In Phase: The first 6-12 participants will receive high-dose vitamin D prior to surgery. The number of participants in this phase will be based on the results of the analyzed research samples.
* Randomized Phase: Because no one knows which of the study options is best, the participant will be "randomized" into one of the study groups: high dose vitamin D or standard dose vitamin D.

  * 48 Participants will be randomized to receive high-dose vitamin D or standard-dose vitamin D. Randomization means that the participants are put into a group by chance. Neither the participant nor the research doctor will choose what group the participant will be in. The participant will have an equal chance of getting assigned to each arm (like flipping a coin). The randomized phase will enroll to two groups at the same time:

    * Group A: 24 participants with a recent diagnosis of stage I, II or III colon cancer will be randomized to receive high-dose vitamin D or standard-dose vitamin D.
    * Group B: 24 participants with resectable liver metastases from colon cancer will be randomized to receive high-dose vitamin D or standard-dose vitamin D.

Additional research procedures to be performed on study:

* Blood samples will be collected for research purposes (a little more than 2 teaspoons of blood). The samples will be collected immediately prior to the participant's surgery and used to study the vitamin D receptor and pathway, as well as its relationship to colon cancer. Some of this blood will be stored to be used for future cancer research.
* Tumor tissue will be collected for research purposes at the time of the participant surgery. This tissue will also be used to study the vitamin D receptor and pathway, as well as its relationship to colon cancer. Some of the tumor tissue collected will be sent for use in a separate, but related study. In this study, the participant's tumor will be used to grow cell lines. This means the participant's tumor cells will be multiplied in the lab. These cell lines will be used to study the binding sites in the genes of participants and learn more about vitamin D's role in preventing colon cancer.

Vitamin D in Patients With Stage I-III Colon Cancer or Resectable Colon Cancer Liver Metastases

Study to Identify Transcriptional Targets of Vitamin D in Patients With Stage I-III Colon Cancer or Resectable Colon Cancer Liver Metastases Receiving Preoperative Vitamin D Supplementation.

Compare VDR binding sites between supplementation arms (high-dose versus standard-dose), between malignant versus adjacent benign colon or liver tissue in those receiving high-dose vitamin D, and between primary colon tumors versus liver metastases in patients exposed to high-dose vitamin D. Laboratory procedures for enriching epithelial cells from the surgical specimen, sonicating cross-linked chromatin, immunoprecipitating VDR-chromatin complexes, and preparing DNA libraries for massively parallel sequencing will be refined.

The goal is to infer direct transcriptional targets of VDR by determining which loci bind VDR and also alter gene expression in response to high-dose vitamin D supplementation. RNA-Seq libraries, prepared from poly(A)+ mRNA and sequenced by Illumina Hi-seq, will be analyzed using Tophat, Cufflinks60 and other new statistical packages to identify consistent differences in transcript levels between tissues exposed to high-dose versus standard-dose vitamin D3 at pre-determined FDRs on the order of 0.01. Stringent tests for statistically significant differences in RNA levels between samples are built into the algorithms for RNA-seq analysis.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Standardization of Laparoscopic Surgery for Right Hemi Colon Cancer (SLRC)	NCT02942238	Overall Surviva... Postoperative C... Metastasis Stage, Colon Ca...	CME D3	18 Years - 75 Years	Ruijin Hospital
Vitamin D in Patients With Stage I-III Colon Cancer or Resectable Colon Cancer Liver Metastases	NCT02172651	Stage, Colon Ca... Stage I-III Col... Stage IV Colon ...	Vitamin D3 Placebo	18 Years -	Dana-Farber Cancer Institute
Standardization of Laparoscopic Surgery for Right Hemi Colon Cancer (SLRC)	NCT02942238	Overall Surviva... Postoperative C... Metastasis Stage, Colon Ca...	CME D3	18 Years - 75 Years	Ruijin Hospital

Spots Global Cancer Trial Database for stage, colon cancer