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RecruitingNCT04665635Updated Aug 29, 2024

Rectosigmoid Resection vs Seromuscular Tumor Shaving in Ovarian Cancer Surgery

An interventional study of Rectosigmoid resection in Epithelial Ovarian Cancer and Rectosigmoid Cancer Metastatic, sponsored by Cukurova University. Recruiting at 2 sites in Turkey. Open to female participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-08-29.

Sponsored by Cukurova University · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Primary completion was expected by Jan 2025, 1 year 9 months ago, but the record still lists the study as recruiting.
  • Started Mar 2021; still recruiting 5 years 7 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
120
Allocation
Randomized
Ages
18 Years and older
Sex
Female
01

Study summary

Ovarian cancer is the most common cause of death in gynecological cancer. Approximately 75% of epithelial ovarian cancers are detected at an advanced stage. Metastasis and spread are mostly through transperitoneal planting and neighborhood by shedding from the ovarian surface. Metastasis mostly occurs in the peritoneum, omentum, and intestines. The rectosigmoid colon is the main part of the intestine affected by metastasis due to its neighborhood.

Treatment in ovarian cancer consists of a combination of cytoreduction surgery and platinum-based chemotherapy. Surgery is the basis of the treatment, and the main goal is to achieve no residual visible tumor (complete cytoreduction: R0). The residual tumor is one of the main factors affecting survival and reflects the possibilities of the surgical center and the team. Multiple surgical procedures (total hysterectomy, bilateral salpingo-oophorectomy, total omentectomy, peritonectomy, retroperitoneal lymphadenectomies such as pelvic and paraaortic, bowel resections, splenectomy, distal pancreatectomy, various resections related to the bladder, liver, stomach, and diaphragm) may be required to achieve complete or optimal cytoreduction.

In the involvement of the rectosigmoid colon, primarily the serosa, then the muscular layer and finally the mucosa are infiltrated due to the nature of the spread, and therefore most of the involvement is observed in the seromuscular layer. In seromuscular infiltration, resection of the rectosigmoid colon or shaving of tumoral implants without resection can be performed. There are advantages and disadvantages of each method in terms of morbidity. Although there are retrospective studies evaluating recurrence and survival between both methods, as far as investigators know, no randomized prospective studies have been conducted comparing these two methods. The investigators designed this study to compare these two methods successfully applied in our clinic in a prospective randomized study.

02

Conditions studied

  • Epithelial Ovarian Cancer
  • Rectosigmoid Cancer Metastatic

Keywords

  • epithelial ovarian cancer
  • Rectosigmoid resection
  • Seromuscular tumor shaving
  • recurrence
03

In context

Ovarian Neoplasms

2,695 studies on the registry are indexed under Ovarian Neoplasms; 726 are open to participants now.

This study's planned enrollment of 120 is above the median of 60 across 2,030 interventional studies indexed under Ovarian Neoplasms.

Browse Ovarian Neoplasms studies →

Lead sponsor

Cukurova University is the lead sponsor of 247 studies on the registry; 50 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
Female
Accepts healthy volunteers
No

Inclusion criteria

  • Epithelial ovarian cancer
  • Negative colonoscopy ( no mucosal involvement)
  • Intraoperative confirmed serosal or seromuscular rectosigmoid infiltration
  • ECOG \<3
  • ASA \<3

Exclusion criteria

Exclusion Criteria:

  • Nonepithelial ovarian cancers
  • Rectosigmoid mucosal infiltration
  • Total or subtotal colectomy necessitating large bowel infiltrations
  • ECOG >2
  • ASA >2
05

Study design

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

Study arms

  • Active comparator
    Rectosigmoid resection

    Procedure: Rectosigmoid resection

  • Active comparator
    Rectosigmoid seromuscular tumor shaving

    Procedure: Rectosigmoid resection

Interventions

  • ProcedureRectosigmoid resection

    Most of the colorectal involvements are observed in the seromuscular layer. In seromuscular infiltration, resection of the rectosigmoid colon or shaving of tumoral implants without resection can be performed.

    Also known as: Rectosigmoid seromuscular tumor shaving

06

What researchers measure

Primary outcomes

  1. Local pelvic recurrence

    Only the pelvic recurrences determined after the last chemotherapy cycle.

    Time frame: 0-60 months.

  2. Recurrence-free survival

    The time from the last chemotherapy cycle to determination of any recurrence in any location.

    Time frame: 0-60 months.

Secondary outcomes

  1. Cancer specific survival

    Time from diagnosis to the death date due to ovarian cancer.

    Time frame: 0-100 months

  2. Surgery related morbidities

    Any surgery related morbidity during 90 days.

    Time frame: 90 days.

  3. Health related Quality of life

    HRQoL will be assessed with the European Organization for Research and Treatment of Cancer (EORTC) core questionnaire (EORTC QLQ-C30 version 3.0).The QLQ-C30 is a 30-item questionnaire that includes five multiitem functional scales (physical, role, cognitive, emotional, and social), three multi-item symptom scales (fatigue, nausea and vomiting, and pain), five single-item symptom scales (dyspnoea, insomnia, appetite loss, constipation, and diarrhoea), a question on financial impact; and a two-item global quality of life scale.The questionnaire generally has a four-point response scale (1 = "not at all", 4 = "very much").The questionnaire is planned to be performed within 1-2 weeks prior to the surgery (baseline), after 3-4 weeks of surgery before starting of adjuvant chemotherapy, at the end of adjuvant chemotherapy, and every three months in follow-up, until two years of follow-up.

    Time frame: 0-24 months.

  4. Overall survival

    Time from diagnosis to the death date due to any cause.

    Time frame: 0-100 months.

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Study locations

1 of 2 sites recruiting
  • Cukurova University
    Adana, 01330, Turkey
    Not yet recruiting
  • Cukurova University
    Adana, 01330, Turkey
    Recruiting
08

References and documents

Publications

  • Erkilinc S, Karatasli V, Demir B, Cakir I, Can B, Karadeniz T, Gokcu M, Sanci M. Rectosigmoidectomy and Douglas Peritonectomy in the Management of Serosal Implants in Advanced-Stage Ovarian Cancer Surgery: Survival and Surgical Outcomes. Int J Gynecol Cancer. 2018 Nov;28(9):1699-1705. doi: 10.1097/IGC.0000000000001368. PubMed 30371561 ↗
  • Gallotta V, Fanfani F, Vizzielli G, Panico G, Rossitto C, Gagliardi ML, Margariti PA, Salerno MG, Zannoni GF, Pacelli F, Scambia G, Fagotti A. Douglas peritonectomy compared to recto-sigmoid resection in optimally cytoreduced advanced ovarian cancer patients: analysis of morbidity and oncological outcome. Eur J Surg Oncol. 2011 Dec;37(12):1085-92. doi: 10.1016/j.ejso.2011.09.003. Epub 2011 Sep 25. PubMed 21945640 ↗
  • Aletti GD, Podratz KC, Jones MB, Cliby WA. Role of rectosigmoidectomy and stripping of pelvic peritoneum in outcomes of patients with advanced ovarian cancer. J Am Coll Surg. 2006 Oct;203(4):521-6. doi: 10.1016/j.jamcollsurg.2006.06.027. Epub 2006 Aug 23. PubMed 17000396 ↗

Individual participant data

Plan to share: Yes

Supporting information: Study protocol

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 29, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT04665635
Lead sponsor
Cukurova University
Responsible party
Ghanim Khatib (Associate professor, MD, Cukurova University) — Principal investigator
First posted
Dec 11, 2020
Start date
Mar 1, 2021
Primary completion
Jan 2025 (estimated)
Completion
Dec 2026 (estimated)
Last update
Aug 29, 2024

Study contacts

Ghanim Khatib, MD
Contact
ghanim.khatib@gmail.com
+903223386060

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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