Adjuvant Chemotherapy in Clinical Local Advanced CRC Following Preoperational Therapies and pT0-3N0M0 Diagnosis (CANWATCH)

  • STATUS
    Recruiting
  • End date
    Dec 30, 2026
  • participants needed
    650
  • sponsor
    Sixth Affiliated Hospital, Sun Yat-sen University
Updated on 21 March 2022
cancer
chemotherapy regimen
adenocarcinoma
adjuvant chemotherapy

Summary

Adjuvant chemotherapy was unnecessary in pathological stage Ⅱ colorectal cancer following initial treatment of surgery without high risk factors of recurrences. The treatment efficacy of adjuvant chemotherapy for pT1-3N0M0 colorectal cancer following preoperational chemotherapy or chemoradiotherapy remains unclear. Part of clinical local advanced colorectal cancer(cTxN1-2M0), which turn out to be pT0-3N0M0 after preoperational chemotherapy or chemoradiotherapy, might not really need adjuvant chemotherapy due to the down-stage efficacy of the preoperational treatments, or the misleading by lymph nodes false-positive imaging diagnosis.

Description

Colorectal cancer(CRC) nowadays rank the 3rd incidence and the 4th mortality in all cancers worldwide(ref). Although the coloscopy or liquid biopsy screen has improved the early diagnosis of CRC, about 26.5-36.0% of the patients were diagnosed local advanced CRC at the first visit. Part of clinical local advanced colorectal cancer(cTxN1-2M0), which turn out to be pT1-3N0M0 after preoperational chemotherapy or chemoradiotherapy, might not really need adjuvant chemotherapy due to the down-stage efficacy of the preoperational treatments, or the misleading by lymph nodes false-positive imaging diagnosis. Adjuvant chemotherapy was been admitted unnecessary in the pathological stage ⅡA (pT0-3N0M0) CRC following initial treatment of surgery without high risk factors of recurrences. The treatment efficacy of adjuvant chemotherapy for pT1-3N0M0 CRC following preoperational chemotherapy or chemoradiotherapy remains unclear. The aim of this study is to evaluate the efficacy/safety of adjuvant chemotherapy in clinical local advanced CRC (cTxN1/2M0) following preoperational adjuvant therapies and pathologically proved pT0-3N0M0 CRC. Patients are randomized to control group(down-staged pT0-3N0M0 CRC with 6 to 8 periods adjuvant chemotherapy) and experimental group(watch group, down-staged pT0-3N0M0 CRC without adjuvant chemotherapy). The primary endpoint is the 3-years disease-free survival after surgery. Secondary endpoints evaluate long-term clinical outcomes, in particular overall survival and side effect of chemotherapy.

Details
Condition Colorectal Cancer, Adjuvant Chemotherapy
Treatment Adjuvant chemotherapy, wait and watch
Clinical Study IdentifierNCT03748485
SponsorSixth Affiliated Hospital, Sun Yat-sen University
Last Modified on21 March 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

preoperative clinical tumor stage III (TxN1-2M0)CRC
pathological proved CRC adenocarcinoma by endoscopic biopsy
Post operational pathological T0-3N0M0 without high risk factors of recurrence
Patient able to understand and sign written informed consent

Exclusion Criteria

Other malignant tumors history
Complications need emergency surgery (occlusion, sub-occlusion, massive hemorrhage and abscesses)
Colorectal tumor extension towards abdominal wall and/or adjacent organ making liver R0 resection impossible immediately
Non resectable lymph node metastasis
American Society of Anesthesiologists (ASA) grading≥ IV and/or, Eastern Cooperative Oncology Group(ECOG) score≥ 2
Physical or psychological dependence
Pregnant or breast feeding women
Not controlled pre-operational infection
Enrolled in other clinical trials within 4 weeks
Other clinical or laboratorial condition not recommended by investigators
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