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Trial Title:
Pancreas Resection for Colorectal Metastasis: Retrospective Study
NCT ID:
NCT05714475
Condition:
Pancreas Metastases
Colorectal Cancer
Conditions: Official terms:
Colorectal Neoplasms
Neoplasm Metastasis
Pancrelipase
Conditions: Keywords:
pancreas
pancreatectomy
pancreas resection
colorectal metastasis
whipple
adenocarcinoma
follow up
Study type:
Observational
Overall status:
Recruiting
Study design:
Time perspective:
Retrospective
Intervention:
Intervention type:
Procedure
Intervention name:
Pancreas surgery
Description:
Criteria
Inclusion Criteria:
- Isolated pancreatic metastases from Colorectal cancer
- Previous surgery for colorectal cancer
- Surgically manageable lesions: duodenal-pancreatectomy surgical removal of
metastatic repetitions in pancreas
pancreaticoduodenectomy total-pancreatectomy distal-pancreatectomy other metastases
resection
Arm group label:
Pancreas resection for colorectal metastasis
Summary:
The aim of this study is to collect data from different centres to obtain a larger case
series and enable a better definition of the outcomes after pancreatic metastasectomy
from primary colorectal cancer. To evaluate the possible benefits of surgery, we intend
to retrospectively analyze the outcome of patients in whom pancreatic metastases have
been surgically treated.
Primary objective;
1. To evaluate feasibility and safety of pancreas resection in metastatic colorectal
cancer
2. To evaluate oncological outcome at six months from surgical procedure
Secondary objective:
1. To evaluate oncological outcome at 12 months from surgical procedure
Detailed description:
Metastases to the Pancreas are quite rare and account for less than 5% of pancreatic
malignancies diagnosed in living patients.
In autopsy cases of malignant tumours, the incidence of pancreatic secondary tumours
reaches 15%.
The metastases are predominantly of epithelial origin, most commonly from lung, stomach,
small bowel, colon-rectum, kidney , breast , liver , ovary ,melanoma and urinary bladder.
It is largely described that resection of isolated metastasis to the lung or liver from
primary tumour leads to improved survival; yet there is no consensus about the benefit of
pancreas resection for metastases and the gold standard treatment is still not well
defined.
The lack of data for pancreas metastases resections depends on low incidence and high
perioperative risks. However, the improvement in morbidity and mortality rates after
pancreaticoduodenectomy made the indication for this operation acceptable.
One of the larger series concluded that an aggressive surgical approach might be
warranted if the patient can be rendered free of disease.
The majority of case series referred to renal cell carcinoma and resection for CCR are
episodic. However there are several reports of solitary resected pancreatic metastases
from colorectal cancer There is currently very limited experience with the surgical
resection of isolated pancreatic colorectal metastases, and the role of surgery in the
management of these patients is still debated.
To date, no prospective randomized or case-controlled studies have been performed to
evaluate the role of surgical resection. Additionally, many of the existing retrospective
studies are limited because of the small number of patients who were treated during
prolonged periods of time.
Aim of the study The aim of this study is to collect data from different centres to
obtain a larger case series and enable a better definition of the outcomes after
pancreatic metastasectomy from primary colorectal cancer. To evaluate the possible
benefits of surgery, the investigators intend to retrospectively analyze the outcome of
patients in whom pancreatic metastases have been surgically treated.
The investigators launched the study aiming at demonstrating that pancreatic resection
for colorectal metastases may be a safe and feasible procedure in selected patients and
may provide long-term survival. The investigators sought to address the role of surgical
resection and survival benefit from surgery. The investigators suppose to achieve a good
prognosis with a median survival close to that observed after resection of hepatic
metastases.
The guidelines for the treatment of colorectal cancer recommend resection of hematogenous
metastases if they are deemed resectable.
Study design This study is an international multicenter retrospective cohort study to
assess the outcomes of patients that underwent pancreas resection for solitary colorectal
metastasis.
Aim of surgical interventions is to remove metastases in association to radical
lymphadenectomy thus to achieve R0 result.
Patient data will be retrospectively analyzed and demographic characteristics,
comorbidity status, clinical and radiological findings, treatment strategies , 30-day
morbidity and mortality, oncological outcomes at 6 and 12 months will be evaluated.
Criteria for eligibility:
Study pop:
patients underwent pancreas surgery for colorectal metastasis
Sampling method:
Non-Probability Sample
Criteria:
Inclusion Criteria:
- Isolated pancreatic metastases from Colorectal cancer
- Previous surgery for colorectal cancer
- Surgically manageable lesions: duodenal-pancreatectomy surgical removal of
metastatic repetitions in pancreas
- Other procedures:
total-pancreatectomy distal-pancreatectomy other metastases resection
- R0 resection
- no signs of peritoneal metastasis or tumor manifestations outside of the pancreas.
- CT Scan before surgery
Exclusion Criteria:
- metastases from different malignancies
- other malignancies
- surgically unmanageable lesions
- Multiple synchronous colorectal metastasis
Gender:
All
Minimum age:
18 Years
Maximum age:
N/A
Healthy volunteers:
No
Locations:
Facility:
Name:
Ospedale Generale di zona Moriggia Pelascini
Address:
City:
Gravedona
Zip:
22015
Country:
Italy
Status:
Recruiting
Contact:
Last name:
Francesco Palmieri, MD
Phone:
00393488615589
Email:
dr.francescopalmieri@gmail.com
Investigator:
Last name:
Francesco Lancellotti, MD
Email:
Sub-Investigator
Start date:
January 1, 2023
Completion date:
June 30, 2023
Lead sponsor:
Agency:
Ospedale Generale Di Zona Moriggia-Pelascini
Agency class:
Other
Source:
Ospedale Generale Di Zona Moriggia-Pelascini
Record processing date:
ClinicalTrials.gov processed this data on November 12, 2024
Source: ClinicalTrials.gov page:
https://clinicaltrials.gov/ct2/show/NCT05714475