scholarly journals Piver Type II vs. Type III Hysterectomy in the Treatment of Early-Stage Cervical Cancer: Midterm Follow-up Results of a Randomized Controlled Trial

2018 ◽  
Vol 8 ◽  
Author(s):  
Hengzi Sun ◽  
Dongyan Cao ◽  
Keng Shen ◽  
Jiaxin Yang ◽  
Yang Xiang ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Randomized Controlled Trial ◽  
Early Stage ◽  
Controlled Trial ◽  
Type Ii ◽  
Type Iii ◽  
Randomized Controlled ◽  
Early Stage Cervical Cancer

scholarly journals Robot-assisted approach to cervical cancer (RACC): an international multi-center, open-label randomized controlled trial

2019 ◽  
Vol 29 (6) ◽  
pp. 1072-1076 ◽  
Author(s):  
Henrik Falconer ◽  
Kolbrun Palsdottir ◽  
Karin Stalberg ◽  
Pernilla Dahm-Kähler ◽  
Ulrika Ottander ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Randomized Controlled Trial ◽  
Early Stage ◽  
Controlled Trial ◽  
Recurrence Free Survival ◽  
Robot Assisted ◽  
Open Label ◽  
Free Survival ◽  
Randomized Controlled ◽  
Early Stage Cervical Cancer

BackgroundRadical hysterectomy with pelvic lymphadenectomy represents the standard treatment for early-stage cervical cancer. Results from a recent randomized controlled trial demonstrate that minimally invasive surgery is inferior to laparotomy with regards to disease-free and overall survival.Primary ObjectiveTo investigate the oncologic safety of robot-assisted surgery for early-stage cervical cancer as compared with standard laparotomy.Study HypothesisRobot-assisted laparoscopic radical hysterectomy is non-inferior to laparotomy in regards to recurrence-free survival with the advantage of fewer post-operative complications and superior patient-reported outcomes.Trial DesignProspective, multi-institutional, international, open-label randomized clinical trial. Consecutive women with early-stage cervical cancer will be assessed for eligibility and subsequently randomized 1:1 to either robot-assisted laparoscopic surgery or laparotomy. Institutional review board approval will be required from all participating institutions. The trial is coordinated from Karolinska University Hospital, Sweden.Major Inclusion/Exclusion CriteriaWomen over 18 with cervical cancer FIGO (2018) stages IB1, IB2, and IIA1 squamous, adenocarcinoma, or adenosquamous will be included. Women are not eligible if they have evidence of metastatic disease, serious co-morbidity, or a secondary invasive neoplasm in the past 5 years.Primary EndpointRecurrence-free survival at 5 years between women who underwent robot-assisted laparoscopic surgery versus laparotomy for early-stage cervical cancer.Sample SizeThe clinical non-inferiority margin in this study is defined as a 5-year recurrence-free survival not worsened by >7.5%. With an expected recurrence-free survival of 85%, the study needs to observe 127 events with a one-sided level of significance (α) of 5% and a power (1−β) of 80%. With 5 years of recruitment and 3 years of follow-up, the necessary number of events will be reached if the study can recruit a total of 768 patients.Estimated Dates for Completing Accrual and Presenting ResultsTrial launch is estimated to be May 2019 and the trial is estimated to close in May 2027 with presentation of data shortly thereafter.Trial RegistrationThe trial is registered at ClinicalTrials.gov (NCT03719547).

scholarly journals Minimally invasive versus open radical trachelectomy for early-stage cervical cancer: protocol for a multicenter randomized controlled trial in China

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaopei Chao ◽  
Lei Li ◽  
Ming Wu ◽  
Huanwen Wu ◽  
Shuiqing Ma ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Randomized Controlled Trial ◽  
Early Stage ◽  
Controlled Trial ◽  
Disease Free Survival ◽  
Radical Trachelectomy ◽  
Free Survival ◽  
Randomized Controlled ◽  
Early Stage Cervical Cancer ◽  
Disease Free

Abstract Background There are limited data comparing the oncologic and fertility outcomes of patients with early-stage cervical cancer (CC) treated by minimally invasive radical trachelectomy (MIRT) or abdominal radical trachelectomy (ART). The purpose of this multicenter study is to compare the oncologic and fertility outcomes of patients treated by MIRT or ART in a randomized controlled manner in China. Methods This is a noninferiority, randomized controlled trial performed at 28 Chinese centers; the study is designed to compare the oncologic and fertility outcomes of patients treated by MIRT (robot-assisted or laparoscopic RT) or ART. Patients will be recruited if they have been diagnosed with stage IA1 (with lymphovascular space invasion), IA2, or IB1 CC (with a maximum tumor diameter ≤ 2 cm) in the FIGO 2009 staging system and histological subtypes of squamous carcinoma, adenocarcinoma, or adenosquamous carcinoma and if they are also aged 18 to 40 years. These candidates will be randomly assigned to undergo MIRT or ART. The primary endpoint will be disease-free survival. Secondary endpoints will consist of overall and disease-free survival rates, fertility outcomes, and quality of life. A total of 414 patients are needed to accomplish the study goal, with 90.1% power at a 0.050 significance level to detect an equivalence hazard ratio of 0.75 in the ART group, considering 20% loss to follow-up. Discussion The results of the trial should provide robust evidence to surgeons regarding options for the surgical approach in patients with early-stage CC who have a strong willingness to preserve fertility. Trial registration ClinicalTrials.gov NCT03739944. Registered on November 14, 2018

Prediction of motivational impairment: 12-month follow-up of the randomized-controlled trial on extended early intervention for first-episode psychosis

2017 ◽  
Vol 41 (1) ◽  
pp. 37-41 ◽  
Author(s):  
W.C. Chang ◽  
V.W.Y. Kwong ◽  
G.H.K. Chan ◽  
O.T.T. Jim ◽  
E.S.K. Lau ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Early Intervention ◽  
Early Stage ◽  
Controlled Trial ◽  
First Episode Psychosis ◽  
First Episode ◽  
Randomized Controlled ◽  
Premorbid Adjustment ◽  
Episode Psychosis

AbstractBackgroundAmotivation is prevalent in first-episode psychosis (FEP) patients and is a major determinant of functional outcome. Prediction of amotivation in the early stage of psychosis, however, is under-studied. We aimed to prospectively examine predictors of amotivation in FEP patients in a randomized-controlled trial comparing a 1-year extension of early intervention (Extended EI, 3-year EI) with step-down psychiatric care (SC, 2-year EI).MethodsOne hundred sixty Chinese patents were recruited from a specialized EI program for FEP in Hong Kong after they have completed this 2-year EI service, randomly allocated to Extended EI or SC, and followed up for 12 months. Assessments on premorbid adjustment, onset profiles, baseline symptom severity and treatment characteristics were conducted. Data analysis was based on 156 subjects who completed follow-up assessments.ResultsAmotivation at 12-month follow-up was associated with premorbid adjustment, allocated treatment condition, and levels of positive symptoms, disorganization, amotivation, diminished expression (DE) and depression at study intake. Hierarchical multiple regression analysis revealed that Extended EI and lower levels of DE independently predicted better outcome on 12-month amotivation.ConclusionOur findings indicate a potentially critical therapeutic role of an extended specialized EI on alleviating motivational impairment in FEP patients. The longer-term effect of Extended EI on amotivation merits further investigation.

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