Esophageal cancer
Conditions
Interventions
A: Esophagectomy with prophylactic supraclavicular node (104) dissection (Control arm, D2 dissection)
B: Esophagectomy without prophylactic supraclavicular node (104) dissection (Intervention arm, D2-
Sponsors
Tsubosa Yasuhiro
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: (1) Histologically proven squamous cell carcinoma, adenosquamous carcinoma, or basaloid cell carcinoma. (2) Primary tumor located in the upper thoracic or the mid-thoracic portion of the esophagus and all lesions located in the thoracic esophagus. (3) Multiple tumors are eligible. Secondary lesion in the cervical esophagus which is indicated for endoscopic resection (EMR/ESD) is eligible. (4) Clinical Stage I, II, III, or IVA (except for T4) based on the cervical to abdominal contrast-enhanced CT (UICC-TNM 8th edition). In case patients have undergone neoadjuvant chemotherapy (DCF based on JCOG1109 or CF based on JCOG9907), they are eligible if only pretreatment stages are I, II, III, or IVA (except for T4) and currently there is no evidence of T4 nor adjacent organ involvement from metastatic lymph nodes. (5) Aged 18 to 80 years old. (6) ECOG Performance status 0 or 1. (7) Fit for one-stage right-thoracoabdominal esophagectomy including minimally invasive procedure (thoracoscopy, laparoscopy, and robot-assisted) to accomplish R0 resection. (8) No prior history of systemic therapy for other malignancies, or radiotherapy to the cervical, thoracic, or upper abdominal regions within the past 5 years. (9) No previous anterior neck surgery. No previous surgery for right lung cancer. (10) No previous treatment for esophageal cancer except for the followings; 1. Non-curative resection for the primary tumor by EMR/ESD. 2. Neoadjuvant chemotherapy defined in (4). 3. Complete resection by EMR/ESD for asynchronous multiple lesion. (11) Major organ function is preserved. 1. WBC>=3,000/mm3 2. PLT>=100,000/mm3 3. T-bil=95% (room air) (12) Written informed consent
Exclusion criteria
Exclusion criteria: (1) Synchronous or metachronous (within 5 years) malignancies. (2) Infectious disease requiring systemic treatment. (3) Body temperature of 38 degrees Celsius or higher. (4) Female during pregnancy, within 28 days of postparturition, or during lactation. (5) Psychological disorder difficult to participate in this clinical study. (6) Receiving continuous systemic corticosteroid or immunosuppressant treatment. (7) Poorly controlled diabetes mellitus even with continuous use of insuline or hypoglycemic agents. (8) Uncontrolled arterial hypertension. (9) History of unstable angina pectoris within three weeks or myocardial infarction within six months before registration. (10) Uncontrolled valvular disease, dilated cardiomyopathy, and hypertrophic cardiomyopathy. (11) Severe emphysema, interstitial pneumonia or pulmonary fibrosis based on chest CT.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Overall survival | — |
Secondary
| Measure | Time frame |
|---|---|
| Relapse free survival, postoperative complications, delayed toxicity, incidence of supraclavicular node (104) recurrence, incidence of only supraclavicular node (104) recurrence, incidence of salvage cervical surgery / chemoradiotherapy / radiotherapy, proportion of synchronous cervical and abdominal procedure, operation time, and number of operating surgeons. | — |
Contacts
Public ContactYasuhiro Tsubosa
Shizuoka Cancer Center
Outcome results
None listed