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RecruitingNCT02222844IMPRESSUpdated Oct 17, 2024

Improving Radical Treatment Through MRI Evaluation of Pelvic Sigmoid Cancers

An interventional study of Preoperative MRI scan in Cancer, Colorectal Neoplasms and Colon, Sigmoid, sponsored by Imperial College London. Recruiting at 16 sites in United Kingdom. Open to participants aged 16 Years and older. Per ClinicalTrials.gov, last updated 2024-10-17.

Sponsored by Imperial College London · Not applicable, Interventional, and Diagnostic

Phase
Not applicable
Study type
Interventional
Enrollment
244
Allocation
Randomized
Ages
16 Years and older
Sex
All
01

Study summary

Patients with suspected or proven sigmoid colon adenocarcinoma, eligible for curative treatment whose MRI can be reviewed prior to surgery and has no decision regarding radical treatment are eligible. Patient are randomised to the control arm which the standard care of preoperative CT imaging and subsequent discussion by the Multidisciplinary Team or the interventional arm which has the additional use of MRI imaging and subsequent discussion by the Multidisciplinary Team. Patients are followed up at 1 and 3 years together with QoL questionnaires.

Read the detailed description

A randomised phase II multicentre trial, IMPRESS will determine whether the use of MRI imaging in staging sigmoid cancers results in a change to the treatment plan by identifying more high risk tumours compared to those patients who were staged using CT imaging. The proposed intervention will be additional radiological and pathological assessment and the reporting of supplementary diagnostic information which would not otherwise have been available. This may affect treatment according to local MDT protocols and also affect the provision of prognostic information to patients in subsequent discussions.

02

Conditions studied

  • Cancer
  • Colorectal Neoplasms
  • Colon, Sigmoid
  • Magnetic Resonance Imaging
  • General Surgery

Keywords

  • Cancer
  • Colorectal Neoplasms
  • Colon, Sigmoid
  • Magnetic Resonance Imaging
  • General Surgery
  • Postoperative Complications
03

Who can participate

Ages eligible
16 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Have a suspected or proven sigmoid colon adenocarcinoma
  2. Is eligible for curative treatment
  3. Has no irresectable metastatic disease
  4. MRI can be reviewed by an MDT prior to surgery
  5. Has no decision regarding radical treatment
  6. Have provided written informed consent to participate in the study
  7. Be aged 16 years or over

Exclusion criteria

Exclusion Criteria:

  1. Have metastatic disease (including resectable liver metastases)
  2. Have a synchronous second malignancy
  3. Are contraindicated for MRI
  4. Are contraindicated for or have allergy to Buscopan (e.g. glaucoma, small or large bowel obstruction, GFR\<30)
  5. Have severe co-morbidities or previous medical history that prevent the application of eventual chemo/radiotherapy
04

Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
244 participants (estimated)

Study arms

  • No intervention
    Preoperative CT scan

    CT-imaging of chest and abdomen / pelvis before surgery (standard treatment)

  • Experimental
    Preoperative MRI scan

    Standard treatment plus an additional MRI scan before surgery

    Other: Preoperative MRI scan

  • No intervention
    Observational

    Observational only

Interventions

  • OtherPreoperative MRI scan

    Standard preoperative CT of abdomen, chest and pelvis plus interventional preoperative MRI scan.

05

What researchers measure

Primary outcomes

  1. Observational Phase: To measure the difference in staging of sigmoid cancer on CT and MRI.

    Direct comparison of proportion of patients staged as high and low risk for recurrence between CT vs MRI findings

    Time frame: 3 years after last recruit

  2. Randomised Phase: To measure the difference in treatment stratification policy caused by the difference in staging on CT and MRI.

    Direct comparison of proportion of patients undergoing preoperative treatment or extended surgery between patients staged with CT vs MRI

    Time frame: 3 years after last recruit

Secondary outcomes

  1. To compare the recurrence rates of sigmoid tumours staged by CT and MRI according to predicted prognostic risk.

    Comparison of proportion of recurrences in patients staged as low vs high risk on CT vs MRI

    Time frame: 3 years after last recruit

  2. To compare disease free survival of patients staged by CT and MRI according to predicted prognostic risk.

    Kaplan-Meier curves of disease free survival in patients staged as low vs high risk on CT vs MRI

    Time frame: 1 and 3 years after last recruit

  3. To compare the quality of surgery by pathology of patients staged by CT and MRI according to predicted prognostic risk.

    Grade of specimen using pathology TNM8 stratified by TNM8 staging on CT vs MRI

    Time frame: 5 years

  4. To compare CRM positivity rates on pathology of patients staged by CT and MRI according to predicted prognostic risk

    CRM positivity rates on pathology in patients staged as low vs high risk on CT vs MRI

    Time frame: 3 years after last recruit

  5. To compare baseline and post-treatment stage on imaging against pathology and clinical outcomes of patients staged by CT and MRI.

    Comparison of proportion of patients staged as low vs high risk on CT vs MRI with pathology high and low risk and against outcomes

    Time frame: 3 years after last recruit

  6. To compare perioperative morbidity and mortality of patients staged by CT and MRI according to predicted prognostic risk.

    Comparison of perioperative morbidity of patients stratified by preoperative treatment between patients staged with CT vs MRI

    Time frame: 3 years after last recruit

  7. To compare quality of life of patients staged by CT and MRI according to predicted prognostic risk.

    Comparison of quality of life between patients staged with CT vs MRI by questionnaire (EORTC QLQ-CR29)

    Time frame: 1 and 3 years after last recruit

  8. To compare permanent defunctioning stoma rates in patients staged by CT and MRI according to predicted prognostic risk.

    Comparison of proportion of stomas not reversed within 3 years postoperative follow-up in patients staged with CT vs MRI

    Time frame: 3 years after last recruit

06

Study locations

15 of 16 sites recruiting
  • Hinchingbrooke Hospital
    Huntingdon, Cambridgeshire PE29 6NT, United Kingdom
    Recruiting
  • Leighton Hospital
    Crewe, Cheshire CW1 4QJ, United Kingdom
    Recruiting
  • University Hospital of North Tees
    Stockton-on-Tees, County Durham TS19 8PE, United Kingdom
    Recruiting
  • Croydon University Hospital
    Thornton Heath, Croydon CR7 7YE, United Kingdom
    Recruiting
  • Chesterfield Royal
    Chesterfield, Derbyshire SS4 5BL, United Kingdom
    Recruiting
  • Queen Alexandra Hospital
    Portsmouth, Hampshire PO6 3LY, United Kingdom
    Recruiting
  • St Mark's Hospital
    Middlesex, Harrow HA1 3UJ, United Kingdom
    Recruiting
  • Maidstone Hospital
    Maidstone, Kent ME16 9QQ, United Kingdom
    Recruiting
  • Queen Elizabeth the Queen Mother Hospital
    Margate, Kent CT9 4AN, United Kingdom
    Recruiting
  • North Manchester General Hospital
    Crumpsall, Manchester M8 5RB, United Kingdom
    Recruiting
  • University Hospital of South Manchester & Manchester Royal Infirmary
    Wythenshawe, Manchester M23 9LT, United Kingdom
    Recruiting
  • Harrogate District Hospital
    Harrogate, North Yorkshire HG2 7SX, United Kingdom
    • David Leinhardt · Contact
    • Lisa Jones · Contact · Lisa.Jones@hdft.nhs.uk
    • David Leinhardt · Principal investigator
    Recruiting
  • Musgrove Park Hospital
    Taunton, Somerset TA1 5DA, United Kingdom
    Recruiting
  • Yeovil District Hospital
    Yeovil, Somerset BA21 4AT, United Kingdom
    Active, not recruiting
  • Royal Marsden Hospital
    Sutton, Surrey SM2 5PT, United Kingdom
    Recruiting
  • Salisbury District Hospital
    Salisbury, Whiltshire SP2 8BJ, United Kingdom
    Recruiting
07

Registry details

Key details

Study ID
NCT02222844
Lead sponsor
Imperial College London
Collaborators
Pelican Cancer Foundation
Responsible party
Sponsor
First posted
Aug 21, 2014
Start date
Aug 2014
Primary completion
Dec 2026 (estimated)
Completion
Dec 2031 (estimated)
Last update
Oct 17, 2024

Study contacts

Caroline Martin
Contact
c.martin1@imperial.ac.uk
+44 (0) 7749 655 817
Syvella Ellis
Contact
giclinicaltrials@imperial.ac.uk
+44 (0) 7732 315 234
Gina Brown
principal investigator · Imperial College London

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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