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Dedicated MRI staging versus surgical staging of peritoneal metastases in colorectal cancer patients considered for CRS-HIPEC; the DISCO randomized multicenter trial
- Source :
- BMC Cancer, 21, BMC Cancer, 21, 1, BMC Cancer, 21(1):464. BioMed Central Ltd, BMC Cancer, BMC cancer, 21(1):464. BioMed Central, BMC Cancer, 21(1):464. BioMed Central Ltd., BMC Cancer, Vol 21, Iss 1, Pp 1-8 (2021)
- Publication Year :
- 2021
- Publisher :
- BioMed Central Ltd, 2021.
-
Abstract
- Background Selecting patients with peritoneal metastases from colorectal cancer (CRCPM) who might benefit from cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy (CRS-HIPEC) is challenging. Computed tomography generally underestimates the peritoneal tumor load. Diagnostic laparoscopy is often used to determine whether patients are amenable for surgery. Magnetic resonance imaging (MRI) has shown to be accurate in predicting completeness of CRS. The aim of this study is to determine whether MRI can effectively reduce the need for surgical staging. Methods The study is designed as a multicenter randomized controlled trial (RCT) of colorectal cancer patients who are deemed eligible for CRS-HIPEC after conventional CT staging. Patients are randomly assigned to either MRI based staging (arm A) or to standard surgical staging with or without laparoscopy (arm B). In arm A, MRI assessment will determine whether patients are eligible for CRS-HIPEC. In borderline cases, an additional diagnostic laparoscopy is advised. The primary outcome is the number of unnecessary surgical procedures in both arms defined as: all surgeries in patients with definitely inoperable disease (PCI > 24) or explorative surgeries in patients with limited disease (PCI Conclusion This randomized trial determines whether MRI can effectively replace surgical staging in patients with CRCPM considered for CRS-HIPEC. Trial registration Registered in the clinical trials registry of U.S. National Library of Medicine under NCT04231175.
- Subjects :
- Cancer Research
Colorectal cancer
CARCINOMATOSIS
030230 surgery
law.invention
Study Protocol
Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14]
0302 clinical medicine
Randomized controlled trial
LAPAROSCOPY
law
Surgical oncology
Laparoscopy
RC254-282
Peritoneal Neoplasms
INDEX
Netherlands
medicine.diagnostic_test
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Cytoreduction Surgical Procedures
Combined Modality Therapy
Magnetic Resonance Imaging
Tumor Burden
Oncology
030220 oncology & carcinogenesis
Urological cancers Radboud Institute for Health Sciences [Radboudumc 15]
Hyperthermic intraperitoneal chemotherapy
Radiology
HYPERTHERMIC INTRAPERITONEAL CHEMOTHERAPY
Colorectal Neoplasms
RCT
MRI
medicine.medical_specialty
Colorectal peritoneal metastases
Surgical staging
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
SDG 3 - Good Health and Well-being
Multicenter trial
Genetics
medicine
MANAGEMENT
Humans
COMPUTED-TOMOGRAPHY
CRS-HIPEC
Neoplasm Staging
business.industry
Magnetic resonance imaging
medicine.disease
Clinical trial
Surgical staging, MRI
CYTOREDUCTIVE SURGERY
Sample Size
Quality of Life
Tomography, X-Ray Computed
business
Subjects
Details
- Language :
- English
- ISSN :
- 14712407
- Volume :
- 21
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Cancer
- Accession number :
- edsair.doi.dedup.....3443c6f0c807c91427727ec8ec08e368