The aim of this study is evaluate the effect of two different surgical treatment on lower rectal cancer after almost clinical complete response(almost-cCR). All almost clinical complete response(almost-cCRs) were entered into two groups randomly. The estimated sample size of the minimal operation group was 221, and 221 in the Mile's group. Three years' progression-free survival(PFS) and overall survival(OS) were compared.
Patients with low rectal cancer were treated with neoadjuvant radiotherapy, and two cycles of XELOX at the interval. All almost-cCRs after neoadjuvant treatment were randomly divided into minimal operation group or Mile's group. All cCRs were treated with "watch and wait". Patients after local recurrence were randomly divided into minimal operation group or Mile's group. If pathological result was pathological staging 3 after neoadjuvant therapy(ypT3) in minimal operation group or local postoperative recurrence occurred, patients need supplement of abdominoperineal resection (APR). With 3 years follow-up,the main research goals are 3 years of progression-free survival(PFS) and overall survival(OS). Secondary endpoints are side effects of chemotherapy, assessment of quality of life, surgical complications, adverse prognostic factors and so on.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
477
Transanal surgery could Preserve anus to reduce trauma and improve the quality of life
Miles surgery cut off the anus, enlarge the trauma and reduce the quality of life.
After preoperative radiochemotherapy, two cycles of XELOX were given at the interval of waiting operation.
Liaoning cancer Hospital
Shenyang, Liaoning, China
RECRUITINGPFS
The progression-free survival of 3 years
Time frame: three years
OS
3 years of overall survival time
Time frame: three years
carcinoembryonic antigen(CEA)
The level of carcinoembryonic antigen in blood
Time frame: every 3 months,for 2 years
carbohydrate antigen 19-9(CA-199)
The level of carbohydrate antigen 19-9 in blood
Time frame: every 3 months,for 2 years
International Index of Erectile Function-15
Describe the function of Erectile ,only for male patients
Time frame: every 3 months ,for 2 years
International prostate symptom score
Describe the function of prostate,only for male patients
Time frame: every 3 months ,for 2 years
Female sexual function index
Describe the function of sexual for female patients
Time frame: every 3 months,for 2 years
Wexner incontinence score
Describe the degree of Anus incontinence
Time frame: every 3 months,for 2 years
QOL
Describe the quality of life for tumor patients
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Time frame: every 3 months,for 2 years