The aim of this clinical trial is to assess the oncologic safety of minimally invasive pelvic exenteration in patients with recurrence or persistence of cervical or vaginal cancer with pelvic location, suitable for pelvic exenteration according to the ESGO guidelines (European Society of Gynecological Oncology). The primary aim is to assess the 3-year disease-free survival (DFS). The secondary aim is to assess the 3-year overall survival (OS), the intraoperative and post-operative complication rate, and the patient's quality of life.
Patients will be considered pre-operatively eligible in case of recurrence/persistence of cervical or vaginal cancer with pelvic location, suitable for pelvic exenteration according to the ESGO guidelines (European Society of Gynecological Oncology). Histological diagnosis of recurrent or persistent disease obtained with biopsy performed during examination under anesthesia or US-guided biopsy, or RECIST 1.1 (Response Evaluation Criteria in Solid Tumors) criteria of progressive disease are required, as by standard clinical practice. All patients will undergo MRI pelvic scan and PET/CT scan within one month before the surgery, as by standard clinical practice. After obtaining oral and written informed consent, patients will be registered. Pelvic exenteration will be performed with the aim of removing a single specimen with negative surgical margins. A mini-laparotomy of up to 7 cm will be allowed to complete the reconstructive phase of the procedure. Registration data has to be entered to an electronic Case Report Form (eCRF). The Principal Investigator (PI) of the study will independently take responsibility for the development of an electronic Case Report Form (CRF) for data collection.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
64
If all criteria are met, patients are registered. The patient is enrolled before the surgery, at the time of pelvic evaluation under anaesthesia. A diagnostic laparoscopic assessment can be performed before the operation to exclude peritoneal metastasis. The experimental procedure in this protocol involves the use of a minimally invasive approach (robot-assisted or laparoscopic) for performing pelvic exenteration.
Policlinico Agostino Gemelli IRCCS
Rome, Italy
RECRUITINGDisease free survival (DFS)
The primary aim is to assess the 3-year disease free survival
Time frame: From the enrollment for the following three years.
Overall survival (OS)
One of the secondary aim is to assess the overall survival.
Time frame: Survival time is calculated from the date of surgery until the date of death from any cause, or for patients still alive to the date of last clinical follow-up or contact, assessed up to 100 months.
Intraoperative complication rate
Intraoperative complications will be assessed with CTCAE 5.0 classification (Common Terminology Criteria for Adverse Events).
Time frame: During the procedure
Post-operative complication rate
Post-operative complications: will be assessed with Clavien-Dindo classification
Time frame: One month and six months after surgery
Health Related Quality of Life (HRQoL) n.1
Quality of life will be assessed by questionnaires completed by study participants preferably as electronical patient reported outcome measures or during the clinic visit. Questionnaire n. 1 comprises the EORTC QLQ-30 (version 3.0, EORTC: European Organization for Research and Treatment of Cancer; QLQ: Quality-of-Life questionnaire).
Time frame: At baseline and one month, six months, one years and two years after surgery.
Health Related Quality of Life (HRQoL) n. 2
Quality of life will be assessed by questionnaires completed by study participants preferably as electronical patient reported outcome measures or during the clinic visit. Questionnaire n. 2 comprises the EORTC QLQCX24 (European Organization for Research and Treatment of Cancer; QLQ: Quality-of-Life questionnaire)
Time frame: At baseline and one month, six months, one years and two years after surgery.
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