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Brief Title: Local Excision in Downstaged Rectal Cancer
Official Title: Phase III Randomized Trial of Local Excision Versus Total Mesorectal Excision in Downstaged T2T3 Low Rectal Cancer After Radiochemotherapy
Study ID: NCT00427375
Brief Summary: Patients with T2T3 low rectal cancer (size =\< 4 cm) received neoadjuvant treatment (50Gy in 5 weeks with concomitant chemotherapy. Good responders (residual tumour =\< 2 cm) are randomised in local vs rectal excision, 6-8 weeks after treatment. The composite end point evaluates the rate of patients with death, recurrence, major morbidity or severe after effects at two years.
Detailed Description: Rectal excision is the standard surgical treatment of rectal cancer. The risk of mortality and major short and long term morbidity induced by rectal excision justifies new treatments. Local excision is a conservative alternative approach associated with low mortality and morbidity. The purpose of this prospective randomised multicenter study is to compare local vs rectal excision in good responders after radiochemotherapy for low rectal cancer. Patients with T2T3 low rectal cancer, less than 8 cm from the anal verge, size =\< 4 cm, received neoadjuvant treatment, included radiotherapy between 45-55Gy in 5 weeks with concomitant chemotherapy consist of at least, one fluoropyrimidine. Good clinical responders (residual tumour =\< 2 cm) are randomised in local vs rectal excision, 6-8 weeks after treatment. In case of not confirmed pathological response following local excision, complementary rectal excision is required. Bad responders (residual tumour \> 2cm) are treated by primary rectal excision. Follow-up includes digital rectal examination, CT-scan and endorectal ultrasound (if local excision) every 4 months for 2 years, then every 6 months for 3 years.
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Centre Radiothérapie Oncologie Moyenne Garonne - 13 Quai du Docteur Calabet, Agen, , France
Polyclinique Sainte marguerite, Auxerre, , France
Service de Chirurgie Viscérale, Digestive et Cancérologique - CHRU J.Minoz - Boulevard Fleming, Besançon, , France
Service de Radiothérapie - Clinique Tivoli - 220 rue Mandron, Bordeaux, , France
Service de chirurgie digestive - hôpital Saint André - 1 rue Jean Burguet, Bordeaux, , France
Service de Chirurgie Oncologique - Institut Bergonié - 229, cours de l'Argonne, Bordeaux, , France
Service de Chirurgie Digestive - Hôpital ambroise Paré - 9 avenue Charles de Gaulle, Boulogne Billancourt, , France
Service de Chirurgie Générale et Digestive - Hôtel Dieu - CHU Clermont-Ferrand - Boulevard Léon Malfreyt, Clermont-Ferrand, , France
Département de Radiothérapie - Centre Jean Perrin - 58 rue Montalembert, Clermont-Ferrand, , France
Service de Chirurgie Générale et Digestive - Hôpital Beaujon - 100 boulevard du Général Leclerc, Clichy, , France
Centre d'Oncologie et Radiothérapie - rue du Dr Schweitzer, La Rochelle, , France
Service de Chirurgie Digestive - Hôpital A. Michallon - CHU de Grenoble - Boulevard de la Chantourne, La Tronche, , France
Département de Chirurgie Oncologique - Centre Oscar Lambret - 3 rue Combemale, Lille, , France
Service de Chirurgie Générale - Hôpitaux Civils de Lyon, Lyon, , France
Département de Chirurgie Oncologique - Centre Léon Bérard - 28 rue Laennec, Lyon, , France
Institut Paoli Calmette, Marseille, , France
Service de Chirurgie Digestive et viscérale - CHU Timone - 264 rue Saint Pierre, Marseille, , France
Département de Chirurgie Oncologique - CRLC Val d'Aurelle, Montpellier, , France
CHU Nantes, Nantes, , France
Service d'Oncologie-Radiothérapie - Centre antoine Lacassagne - 33 avenue de Valombrose, Nice, , France
Service de Chirurgie Générale - Hôpital Archet II, Nice, , France
CHU Nîmes, Nîmes, , France
Département Médico-Chirurgical de Pathologie Digestive - Hôpital Lariboisière - 2 rue Ambroise Paré, Paris, , France
Service de Cancérologie - Radiothérapie - Hôpital Saint-Louis - 1 avenue Claude Vellefeaux, Paris, , France
Service de Chirurgie Digestive - Hôpital des Diaconnesses - la Croix Saint-Simon - 125 rue d'Avron, Paris, , France
Service de Chirurgie Générale et Digestive - Hôpital Saint-Antoine - 184 rue du Faubourg Saint-Antoine, Paris, , France
Service d'Oncologie - Radiothérapie - Hôpital Tenon - 4 rue de la Chine, Paris, , France
Service de Radiothérapie - Oncologie - Centre Hospitalier Lyon Sud - Hôpitaux Civils de Lyon - 165 chemin du Grand Revoyet, Pierre Benite, , France
Service de Chirurgie Viscérale - CHU pontchaillou - 2 rue Henri Le Guilloux, Rennes, , France
Département des Radiations - Centre Eugène Marquis - rue de la Bataille Flandres-Dunkerque, Rennes, , France
Service de Chirurgie Digestive - CHU Charles Nicolle - 1 rue Germont, Rouen, , France
Service de Radiothérapie-Oncologie - centre Henri Becquerel - rue d'Amiens, Rouen, , France
Service de Chirurgie Oncologique - Centre René Gauducheau - Boulevard Jacques Monod, Saint Herblain, , France
Service de Chirurgie Viscérale - Clinique Charcot - 51-52 rue Commandant Charcot, Sainte Foy les Lyon, , France
Département de Radiothérapie - Centre Paul Strauss - 3 rue de la Porte de l'Hôpital, Strasbourg, , France
Service de Chirurgie Digestive - Hôpital Hautepierre, Strasbourg, , France
Département d'Oncologie Médicale - Institut Claudius Régaud - 20-24 rue du Pont Saint Pierre, Toulouse, , France
Service de Chirurgie Digestive - Hôpital Purpan - Place du Docteur Baylac, Toulouse, , France
Département de Chirurgie Oncologique - Centre Alexis Vautrin - Avenue de Bourgogne, Vandoeuvre les Nancy, , France
Service de Chirurgie Digestive et Générale - CHU Brabois - avenue de Bourgogne, Vandoeuvre les Nancy, , France
Name: Eric RULLIER, Pr.
Affiliation: CHU Bordeaux
Role: PRINCIPAL_INVESTIGATOR