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术中冰冻切片诊断为腺癌及微浸润腺癌的亚肺叶切除术(ECTOP-1019):一项前瞻性、单臂、多中心、III期研究的研究方案

Sublobar resection for adenocarcinoma and minimally invasive adenocarcinoma diagnosed by intraoperative frozen section (ECTOP-1019): a study protocol of prospective, single-arm, multicenter, phase III study.

作者信息

Zheng Shanbo, Deng Chaoqiang, Li Yuan, Zhang Yang, Chen Haiquan

机构信息

Department of Thoracic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.

Institute of Thoracic Oncology, Fudan University, Shanghai, China.

出版信息

J Thorac Dis. 2024 Sep 30;16(9):6286-6291. doi: 10.21037/jtd-24-623. Epub 2024 Sep 18.

Abstract

BACKGROUND

Our previous retrospective study revealed that sublobar resection was appropriate for adenocarcinoma in situ (AIS) and minimally invasive adenocarcinoma (MIA) diagnosed by intraoperative frozen section (FS). However, high-level evidence-based medical data confirming this treatment are still lacking. The aim of the ongoing study is to confirm the efficacy and safety of sublobar resection for AIS and MIA diagnosed by FS.

METHODS

Since October 2023, we have initiated a prospective, single-arm, multicenter, confirmatory phase III trial in China. We plan to enroll a total of 390 patients diagnosed as AIS or MIA by intraoperative FS and who will undergo sublobar resection. The primary endpoint is five-year recurrence-free survival; the secondary endpoints are five-year overall survival, the concordance rate between FS and final pathology, adverse events, proportion of local recurrence and metastasis, the completion rate of sublobar resection and R0 resection.

DISCUSSION

Surgical strategies for small-sized lung cancer that contains ground glass opacity lesions are still controversial. This study will deliver new evidence on the efficacy and safety of sublobar resection without lymph node dissection for cT1N0M0 non-small cell lung cancer (NSCLC) which are diagnosed as AIS or MIA by FS.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT06031181.

摘要

背景

我们之前的回顾性研究表明,亚肺叶切除术适用于通过术中冰冻切片(FS)诊断的原位腺癌(AIS)和微浸润腺癌(MIA)。然而,仍缺乏证实这种治疗方法的高级别循证医学数据。正在进行的这项研究的目的是证实亚肺叶切除术对经FS诊断的AIS和MIA的疗效和安全性。

方法

自2023年10月以来,我们在中国启动了一项前瞻性、单臂、多中心的III期确证性试验。我们计划总共招募390例经术中FS诊断为AIS或MIA且将接受亚肺叶切除术的患者。主要终点是五年无复发生存率;次要终点是五年总生存率、FS与最终病理结果的符合率、不良事件、局部复发和转移的比例、亚肺叶切除术和R0切除的完成率。

讨论

对于包含磨玻璃影病变的小尺寸肺癌的手术策略仍存在争议。本研究将为经FS诊断为AIS或MIA的cT1N0M0非小细胞肺癌(NSCLC)行亚肺叶切除且不进行淋巴结清扫的疗效和安全性提供新的证据。

试验注册

ClinicalTrials.gov标识符:NCT06031181。

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