Fast track multi-discipline treatment (FTMDT trial) versus conventional treatment in colorectal cancer--the design of a prospective randomized controlled study

743 Background: Fast Track Multi-Discipline Treatment (FTMDT) integrates fast-track perioperative treatment (laparoscopic or open surgery) plus XELOX adjuvant chemotherapy for colorectal cancer (CRC). This study aimed to verify the effects of FTMDT model and to clarify the value of laparoscopic surgery in fast-track perioperative treatment. Methods: The study (NCT01080547) was a prospective randomized controlled multi-centers study. Group I (FTMDT) received fast-track treatment plus XELOX chemotherapy (Group Ia received laparoscopic surgery and Group Ib received open surgery). Group II (conventional treatment, CT) received conventional treatment plus mFOLFOX6 chemotherapy (Group IIa received laparoscopic surgery and Group IIb received open surgery). The primary endpoint was total hospital stays during treatment. The secondary endpoints included surgical complications, chemotherapy related adverse events, quality of life and hospitalization costs. Results: Between April 2010 and June 2014, 374 patients were enrolled and 342 patients were finally analyzed. The total hospital stays were shorter in FTMDT than CT (median 13 days vs. 23.5 days, P= 0.0001) but similar between Group Ia and Group Ib (median 13 days vs. 14 days, P= 0.1951). The postoperative hospital stays were shorter in FTMDT than CT (median 6 days vs. 9 days, P= 0.0001) but similar between Group Ia and Group Ib (median 6 days vs. 6 days, P= 0.2160). Resume of flatus and defecation was earlier in FTMDT ( P< 0.05) and Group Ia was the earliest. The in-hospital complication rate was lower in FTMDT (6.40% vs. 14.71%, P= 0.014) but similar between Group Ia and Group Ib. The surgery cost of Group Ib was the lowest ( P< 0.05). The rate of chemotherapy related adverse events was similar between FTMDT and CT( P> 0.05). The EORTC QLQ-C30 physical functioning and fatigue in one week postoperative were better in FTMDT than CT( P< 0.05). Conclusions: FTMDT model enhanced the postoperative recovery of CRC patients. On the premise of fast-track perioperative treatment, laparoscopic surgery showed minor advantage over open surgery which had economic advantages. Clinical trial information: NCT01080547.

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The Effect of Progressive Relaxation Exercise on Physiological Parameters, Pain and Anxiety Levels of Patients Undergoing Colorectal Cancer Surgery: A Randomized Controlled Study

Journal of PeriAnesthesia Nursing ◽

10.1016/j.jopan.2021.08.008 ◽

2021 ◽

Author(s):

Yasemin Ozhanli ◽

Nuray Akyuz

Keyword(s):

Colorectal Cancer ◽

Cancer Surgery ◽

Physiological Parameters ◽

Progressive Relaxation ◽

Randomized Controlled Study ◽

Controlled Study ◽

Colorectal Cancer Surgery ◽

Randomized Controlled ◽

Anxiety Levels ◽

Relaxation Exercise

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Impact of an educational video-based strategy on the behavior process associated with colorectal cancer screening: A randomized controlled study

Cancer Epidemiology ◽

10.1016/j.canep.2009.08.003 ◽

2009 ◽

Vol 33 (3-4) ◽

pp. 216-222 ◽

Cited By ~ 32

Author(s):

Antonio Z. Gimeno-García ◽

Enrique Quintero ◽

David Nicolás-Pérez ◽

Adolfo Parra-Blanco ◽

Alejandro Jiménez-Sosa

Keyword(s):

Colorectal Cancer ◽

Cancer Screening ◽

Colorectal Cancer Screening ◽

Randomized Controlled Study ◽

Controlled Study ◽

Educational Video ◽

Randomized Controlled

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Mindfulness practice reduces cortisol blunting during chemotherapy: A randomized controlled study of colorectal cancer patients

Cancer ◽

10.1002/cncr.30698 ◽

2017 ◽

Vol 123 (16) ◽

pp. 3088-3096 ◽

Cited By ~ 8

Author(s):

David S. Black ◽

Cheng Peng ◽

Alix G. Sleight ◽

Nathalie Nguyen ◽

Heinz-Josef Lenz ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Patients ◽

Mindfulness Practice ◽

Randomized Controlled Study ◽

Controlled Study ◽

Randomized Controlled ◽

Colorectal Cancer Patients

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Fast-track multidisciplinary treatment versus conventional treatment for colorectal cancer: a multicenter, open-label randomized controlled study

BMC Cancer ◽

10.1186/s12885-019-6188-x ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Jun Li ◽

Xiang-Xing Kong ◽

Jiao-Jiao Zhou ◽

Yong-Mao Song ◽

Xue-Feng Huang ◽

...

Keyword(s):

Colorectal Cancer ◽

Laparoscopic Surgery ◽

Hospital Stay ◽

Fast Track ◽

Multidisciplinary Treatment ◽

Controlled Study ◽

Perioperative Treatment ◽

Randomized Controlled ◽

Group 2 ◽

Group 1

Abstract Background Laparoscopic surgery, fast-track perioperative treatment and XELOX chemotherapy are effective strategies for shortening the duration of hospital stay for cancer patients. This trial aimed to clarify the safety and efficacy of the fast-track multidisciplinary treatment (FTMDT) model compared to conventional surgery combined with chemotherapy in Chinese colorectal cancer patients. Methods This trial was a prospective randomized controlled study with a 2 × 2 balanced factorial design and was conducted at six hospitals. Patients in group 1 (FTMDT) received fast-track perioperative treatment and XELOX adjuvant chemotherapy. Patients in group 2 (conventional treatment) received conventional perioperative treatment and mFOLFOX6 adjuvant chemotherapy. Subgroups 1a and 2a had laparoscopic surgery and subgroups 1b and 2b had open surgery. The primary endpoint was total length of hospital stay during treatment. Results A total of 374 patients were randomly assigned to the four subgroups, and 342 patients were finally analyzed, including 87 patients in subgroup 1a, 85 in subgroup 1b, 86 in subgroup 2a, and 84 in subgroup 2b. The total hospital stay of group 1 was shorter than that of group 2 [13 days, (IQR, 11–17 days) vs. 23.5 days (IQR, 15–42 days), P = 0.0001]. Compared to group 2, group 1 had lower surgical costs, fewer in-hospital complications and faster recovery (all P < 0.05). Subgroup 1a showed faster surgical recovery than that of subgroup 1b (all P < 0.05). There was no difference in 5-year overall survival between groups 1 and 2 [87.1% (95% CI, 80.7–91.5%) vs. 87.1% (95% CI, 80.8–91.4%), P = 0.7420]. Conclusions The FTMDT model, which integrates laparoscopic surgery, fast-track treatment, and XELOX chemotherapy, was the superior model for enhancing the recovery of Chinese patients with colorectal cancer. Trial registration ClinicalTrials.gov: NCT01080547, registered on March 4, 2010.

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