Patients with locally advanced gastric adenocarcinoma (CT2-4a N-/+ M0) were selected as study subjects to investigate the safety, efficacy, and feasibility of ICG near-infrared imaging tracing in 3D plus ultra high resolution laparoscopic gastrectomy with lymph node dissection for gastric cancer.
1. Research purpose: Patients with locally advanced gastric adenocarcinoma (CT2-4a N-/+ M0) were selected as study subjects to investigate the safety, efficacy, and feasibility of ICG near-infrared imaging tracing in 3D plus ultra high resolution laparoscopic gastrectomy with lymph node dissection for gastric cancer. 2. Research design: Prospective, single-center, randomized controlled, open-control, parallel assignment, superiority test. 2.1 Case group Group A (Study Group 1, 234 cases): ICG near-infrared imaging tracing in 3D plus ultra high resolution laparoscopic gastrectomy with lymph node dissection; Group B (Study Group 2, 234 cases): ICG near-infrared imaging tracing in ultra high resolution laparoscopic gastrectomy with lymph node dissection; Group C (Control Group 2, 234 cases) 3D laparoscopic gastrectomy with lymph node dissection 2.2 Estimate Sample Size The three-year disease-free survival (DFS) was the main effectiveness evaluation index in this study. The study implemented a superiority test (unilateral), assuming that both the study group's three-year DFS would be better than that of control group, according to previous research results of laparoscopic surgery for locally advanced GC in which the three-year DFS was 65.2%; therefore, the 3-year DFS of the control group would be 65.2%, assuming that the 3-year DFS of the experimental group could be increased by 12% to 77.2%. With an inspection level 0.0125 (unilateral) and an inspection efficiency of 0.8 and using PASS 11 log-rank tests (Lakatos) \[Proportion surviving\] the calculated sample size was N=211; namely, each group needed 211 people, considering cases of possible exclusion and loss to follow-up (10% drop out rate). The final sample size for each group was 234 cases, for a total of 702 cases. 2.3 randomization After laparoscopic exploration and confirmation that the cases complied with the standards, they were included in the randomized groups in this study. SAS 9.2 was used to produce a serial number ranging from 0001 - 702 corresponding to the treatment allocation, which was reserved in the data center and research center. 2.4 Blinding Method: This research adopts an open design. 2.5 Research cycle: Estimated enrollment cycle: complete enrollment within 2 years. Follow-up period: the enrollment of the first case was the starting point for follow-up. And the enrollment of last case to the postoperative pathology report (generally 2 weeks after surgery) was the endpoint of follow-up for secondary outcomes. Three years after the last case was enrolled was the follow-up endpoint for the main outcomes. Estimated time: 2023.12-2025.12 (complete enrollment) to 2028.12 (complete follow-up) Study Objects All patients who meet the inclusion criteria and do not conform to the exclusion criteria are qualified for this study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
702
Indocyanine green tracer is used with 3D plus ultra high resolution laparoscopic gastrectomy with lymph node Dissection for gastric cancer
Fujian Medical University Union Hospital
Fuzhou, Fujian, China
RECRUITING3-year disease free survival rate
Disease-free survival is calculated from the day of surgery to the day of recurrence or death
Time frame: 3 years
Operation time
Operation time
Time frame: 1 day
Total number of retrieved lymph nodes
Total number of retrieved lymph nodes
Time frame: 1 day
Noncompliance rate of lymph node dissection
Noncompliance rate of lymph node dissection
Time frame: 1 day
Relationship between fluorescent lymph nodes in group A and total number of lymph nodes in group A
Relationship between fluorescent lymph nodes in group A and total number of lymph nodes in group A
Time frame: 1 day
Relationship between fluorescent lymph nodes in Group A and positive lymph nodes in Group A (positive rate)
Relationship between fluorescent lymph nodes in Group A and positive lymph nodes in Group A (positive rate)
Time frame: 1 day
Relationship between fluorescent lymph nodes in Group A and negative lymph nodes in Group A (false positive rate)
Relationship between fluorescent lymph nodes in Group A and negative lymph nodes in Group A (false positive rate)
Time frame: 1 day
Relationship between non-fluorescent lymph nodes in Group A and negative lymph nodes in group A (negative rate)
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Relationship between non-fluorescent lymph nodes in Group A and negative lymph nodes in group A (negative rate)
Time frame: 1 day
Relationship between nonfluorescent lymph nodes in Group A and positive lymph nodes in Group A (false negative rate)
Relationship between nonfluorescent lymph nodes in Group A and positive lymph nodes in Group A (false negative rate)
Time frame: 1 day
Relationship between fluorescent lymph nodes in group B and total number of lymph nodes in group B
Relationship between fluorescent lymph nodes in group B and total number of lymph nodes in group B
Time frame: 1 day
Relationship between fluorescent lymph nodes in Group B and positive lymph nodes in Group B (positive rate)
Relationship between fluorescent lymph nodes in Group B and positive lymph nodes in Group B (positive rate)
Time frame: 1 day
Relationship between fluorescent lymph nodes in Group B and negative lymph nodes in Group B (false positive rate)
Relationship between fluorescent lymph nodes in Group A and negative lymph nodes in Group A (false positive rate)
Time frame: 1 day
Relationship between non-fluorescent lymph nodes in Group B and negative lymph nodes in group B (negative rate)
Relationship between non-fluorescent lymph nodes in Group B and negative lymph nodes in group B (negative rate)
Time frame: 1 day
Relationship between nonfluorescent lymph nodes in Group B and positive lymph nodes in Group B (false negative rate)
Relationship between nonfluorescent lymph nodes in Group B and positive lymph nodes in Group B (false negative rate)
Time frame: 1 day
Number of metastatic lymph nodes
Number of metastatic lymph nodes
Time frame: 1 day
Metastasis rate of lymph nodes
Metastasis rate of lymph nodes
Time frame: 1 day
Morbidity and mortality rates
Morbidity and mortality rates
Time frame: 30 day
3-year overall survival rate
3-year overall survival rate
Time frame: 3 years
3-year recurrence pattern
3-year recurrence pattern
Time frame: 3 years
Postoperative recovery course
Postoperative recovery course
Time frame: 30 days
Intraoperative situation
Intraoperative situation
Time frame: 30 days
Postoperative nutritional status
Postoperative nutritional status
Time frame: 3 years
Inflammatory and immune response
Inflammatory and immune response
Time frame: 30 days
Postoperative quality of life (measured by EQ-5D)
Postoperative quality of life (measured by EQ-5D)
Time frame: preoperative, postoperative 1 month and postoperative 1 year