Randomized Trial of Wide Mesorectal Excision Versus Total Mesorectal Excision for Mid Rectal Cancer
- Compare local and distant recurrences in patients with mid-rectal cancer treated with
wide mesorectal surgical excision with straight colorectal anastomosis versus total
mesorectal surgical excision with colonic J pouch coloanal anastomosis.
- Compare the functional, physiological, and anatomical outcomes in these patients
treated with these two surgical procedures.
- Compare disease-free survival and overall survival in these patients treated with these
two surgical procedures.
OUTLINE: This is a randomized, multicenter study. Patients are stratified according to
treatment center. Patients are randomized to 1 of 2 treatment arms.
- Arm I: Patients undergo surgical resection with a wide mesorectal excision followed by
a straight colorectal anastomosis.
- Arm II: Patients undergo surgical resection with a total mesorectal excision followed
by a colonic J pouch coloanal anastomosis. Patients then receive a temporary ileostomy
which is closed 6 weeks later.
Patients are followed at 6 weeks, every 4-6 months for 2 years, every 6 months for 2 years,
and then annually thereafter.
PROJECTED ACCRUAL: A minimum of 800 patients (400 per arm) will be accrued for this study.
Primary Purpose: Treatment
Local recurrence at 3 years
Heah Sieu Min, MD
National Cancer Centre, Singapore