Actively Recruiting

Phase Not Applicable
Age: 40Years +
All Genders
ID06057350

Surgery Versus Endoscopic Resection for Incompletely Removed Early Colon Cancer (SCAR) - a Randomized Controlled Trial

Led by Norwegian Department of Health and Social Affairs · Updated on 2024-02-16

304

Participants Needed

3

Research Sites

104 weeks

Total Duration

On this page

Sponsors

N

Norwegian Department of Health and Social Affairs

Lead Sponsor

H

Hôpital Edouard Herriot

Collaborating Sponsor

AI-Summary

What this Trial Is About

Researchers are conducting a randomized trial comparing two treatments for patients who have undergone incomplete endoscopic removal of early colon cancer. The study aims to evaluate the benefits, potential harms, burdens, environmental impact, and cost-effectiveness of endoscopic full thickness resection (eFTR), a minimally invasive procedure using a colonoscope, compared to standard surgery. The main goals are to assess serious adverse events within 30 days and colon cancer recurrence or spread to lymph nodes or distant sites at 3 years after treatment. Participants are randomly assigned to one of two groups. One group receives surgery following current guidelines, which may include open, laparoscopic, or robotic segmental bowel resection targeting the lymphatic drainage area of the cancer. The other group undergoes eFTR using approved devices, where the scar from the previous removal is identified, documented, and then removed en bloc with the eFTR device mounted on the colonoscope. This design allows a direct comparison of these two approaches. During the study, participants will be closely monitored for safety, cancer recurrence, and other outcomes. Assessments include tracking severe adverse events within 30 days, cancer status at 1, 3, and 5 years, quality of life and functional outcomes, length of hospital stay, readmission rates, and environmental footprint of the procedures. The study also measures technical success and procedure duration. Overall, the trial lasts several years to fully evaluate long-term cancer control and safety.

CONDITIONS

Brief Title

Surgery Versus Endoscopic Resection for Incompletely Removed Early Colon CAnceR

Who Can Participate

Age: 40Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Men and women aged 40 years or older with incomplete endoscopic removal of early colon cancer in the colon (not rectum)
  • No contraindications for colon surgery as evaluated by a multidisciplinary tumor board
  • No poor tumor features such as poor differentiation, lymphovascular invasion, or high-grade tumor budding
  • No signs of disease beyond stage T1N0M0 based on imaging and clinical evaluation
  • Able to identify the resection site by colonoscopy with tattoo or scar
  • No other tumors or polyps larger than 10 mm in the colorectum at randomization
  • Complete colonoscopy with good bowel preparation and documented landmarks
  • No colonic strictures or severe diverticulosis
  • No prior colorectal cancer
  • No other active malignant disease
  • No confirmed or suspected genetic cancer syndromes such as Lynch or polyposis syndromes
  • No inflammatory bowel disease
  • Provided written informed consent before enrollment
Not Eligible

You will not qualify if you...

  • Any individual who does not meet all of the inclusion criteria

AI-Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

1 visit (in-person)

Surgery

Duration - 1 day

Participants randomized to surgery undergo segmental bowel resection according to guidelines to remove early colon cancer.

1 surgical procedure visit

Endoscopic Full-Thickness Resection (EFTR)

Duration - 1 day

Participants randomized to EFTR undergo endoscopic full-thickness resection of the colon cancer scar using approved devices.

1 procedure visit

Post-operative Follow-up

Duration - 30 days

Participants are monitored for adverse events, hospital stay, readmission, and recovery after their procedure.

Approximately 6 post-operative visits

Long-term Monitoring

Duration - 5 years

Participants are followed for up to 5 years to monitor for cancer recurrence, survival, and quality of life.

Annual visits for up to 5 years

Trial Site Locations

Total: 3 locations

1

Vestre Viken Hospital

Oslo, Akershus, Norway, 1346

Actively Recruiting

2

Akershus University Hospital

Oslo, Norway

Actively Recruiting

3

Maria Sklodowska-Curie National Research Institute of Oncology

Warsaw, Poland, 02-781

Actively Recruiting

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Research Team

N

Nastazja Pilonis, MD PhD

M

Michael Bretthauer, MD PhD

How is the study designed?

Study Type

INTERVENTIONAL

Masking

SINGLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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