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Not yet recruitingNCT07847216D3LUpdated Sep 29, 2026

Multicenter Prospective Study Protocol for Validating Surgical Quality Standards in D3 Lymphadenectomy for Oncological Right Hemicolectomy

An observational study in Colon Neoplasms, Right Colon Tumors and Lymphadenectomy, sponsored by Fundació d'investigació Sanitària de les Illes Balears. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-09-29.

Sponsored by Fundació d'investigació Sanitària de les Illes Balears · Observational

Study type
Observational
Model
Cohort
Time perspective
Prospective
Enrollment
120
Ages
18 Years and older
Sex
All
01

Study summary

Introduction: D3 lymphadenectomy (D3L) for right hemicolectomy, proposed by Eastern guidelines, aims to improve oncological outcomes by extending resection to include lymphatic drainage zones beyond those addressed by complete mesocolic excision (CME). However, the absence of standardized anatomopathological quality parameters limits its validation. This multicenter study seeks to validate this criteria, including the "right mesocolic sail," to classify D3L specimens and evaluate its clinical and oncological implications.

Materials and Methods: This prospective, multicenter study involves 11 hospitals in Spain. Surgical specimens from right hemicolectomy with D3L will be analyzed for the presence of the "right mesocolic sail" and classified as complete or incomplete D3L. Standard CME criteria will also be applied. Patient data, surgical details, and oncological outcomes at 3 and 5 years will be collected. Statistical analysis will compare lymph node retrieval, recurrence rates, survival outcomes, and perioperative complications between groups.

Results: The study will validate the right mesocolic sail as a quality parameter for D3L. Preliminary data from prior phases confirm increased lymph node retrieval and the presence of positive nodes in D3L specimens. Additional analyses will determine the impact of D3L on recurrence rates, survival, and perioperative risks.

Discussion: This study aims to provide standardized anatomopathological criteria to evaluate D3L, facilitating comparative studies and addressing its controversial oncological benefits. If validated, the criteria could enhance surgical quality assessment and inform future guidelines.

02

Conditions studied

  • Colon Neoplasms
  • Right Colon Tumors
  • Lymphadenectomy

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Keywords

  • Colon neoplasm
  • D3 lymph node excision
  • Oncological outcomes
  • Pathology quality
  • Multicenter study
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

Patients diagnosed of right colon neoplams undergoing elective or emergency surgery.

Inclusion criteria

  • The study includes consecuent patients undergoing either elective or emergency surgery with a diagnosis of adenocarcinoma or adenoma with dysplasia located in the cecum, ascending colon, or hepatic flexure of the colon.

Exclusion criteria

Exclusion Criteria:

  • Patients under 18 years of age or lack of informed consent for inclusion in the study.
04

Study design

Observational model
Cohort
Time perspective
Prospective
Enrollment
120 participants (estimated)
Target follow-up
5 Years
Patient registry
Yes
Biospecimen retention
Samples with dna

Groups and cohorts

  • Patients with right colon neoplasm

    pPtients over 18 years of age undergoing either elective or emergency surgery with a diagnosis of adenocarcinoma or adenoma with dysplasia located in the cecum, ascending colon, or hepatic flexure of the colon.

    Procedure: Right Colectomy & D3 Lymphadenectomy

Interventions

  • ProcedureRight Colectomy & D3 Lymphadenectomy

    Patients enrolled would receive a right colectomy with dissection of the Lymphoadipose tissue over the superior mesenteric vein, including all the tissue from the ileocolic vessels to the superior right colic vein.

05

What researchers measure

Primary outcomes

  1. Complete or Incomplete D3L

    Validation of Anatomopathological Criteria for Quality Assessment: to validate, through a multicenter study, the effectiveness of new anatomopathological criteria for right hemicolectomy with D3 lymphadenectomy (D3L) in accurately classifying surgical specimens as complete or incomplete D3L.

    Time frame: From enrollment to the end of treatment at 8 weeks

Secondary outcomes

  1. Lymph Node Retrieval

    To evaluate the increase in the number of lymph nodes retrieved following D3L.To confirm the presence of positive lymph nodes within the D3 lymphadenectomy area.

    Time frame: From enrollment to the end of treatment at 8 weeks"

  2. Perioperative Risk Assessment

    To assess whether performing right hemicolectomy with D3L increases perioperative complications.

    Time frame: From enrollment to the end of treatment at 30 days.

  3. Oncological Outcomes

    To examine the potential oncological benefits of D3L, including: Local recurrence rates, Systemic recurrence rates and Three- and five-year survival rates.

    Time frame: From enrollment to the end of treatment at 5 years

06

Study locations

No study locations are listed for this record.

07

References and documents

Publications

  • Sica GS, Anania G, Fiorani C, Siragusa L, Vinci D, Caricato M, Delrio P, Agrusa A, Baldazzi G, Reddavid R, Pellino G; RRoC-STAR Collaborative Group. Standardization of the surgical technique and reporting for radical right colectomy with central vascular ligation and complete mesocolic excision (RRoC-STAR): Delphi consensus. BJS Open. 2025 May 7;9(3):zraf066. doi: 10.1093/bjsopen/zraf066. PubMed 40503608 ↗
  • Balciscueta Z, Balciscueta I, Uribe N, Pellino G, Frasson M, Garcia-Granero E, Garcia-Granero A. D3-lymphadenectomy enhances oncological clearance in patients with right colon cancer. Results of a meta-analysis. Eur J Surg Oncol. 2021 Jul;47(7):1541-1551. doi: 10.1016/j.ejso.2021.02.020. Epub 2021 Feb 26. PubMed 33676793 ↗
  • Garcia-Granero A, Gil-Catalan A, Jeri-McFarlane S, Sancho-Muriel J, Pellino G, Gamundi-Cuesta M, Garcia-Granero E, Gonzalez-Argente FX. Proposal for standardization of laparoscopic D3 lymphadenectomy for right colon cancer. Tech Coloproctol. 2024 Aug 20;28(1):111. doi: 10.1007/s10151-024-02974-8. PubMed 39162907 ↗
  • Garcia-Granero A, Pellino G, Giner F, Frasson M, Grifo Albalat I, Sanchez-Guillen L, Valverde-Navarro AA, Garcia-Granero E. A Proposal for Novel Standards of Histopathology Reporting for D3 Lymphadenectomy in Right Colon Cancer: The Mesocolic Sail and Superior Right Colic Vein Landmarks. Dis Colon Rectum. 2020 Apr;63(4):450-460. doi: 10.1097/DCR.0000000000001589. PubMed 31996584 ↗
  • Emmanuel A, Haji A. Complete mesocolic excision and extended (D3) lymphadenectomy for colonic cancer: is it worth that extra effort? A review of the literature. Int J Colorectal Dis. 2016 Apr;31(4):797-804. doi: 10.1007/s00384-016-2502-0. Epub 2016 Jan 30. PubMed 26833471 ↗

Individual participant data

Plan to share: No — No individual participant data (IPD) will be shared because the study was not designed with a data-sharing framework, and the informed consent and ethics approval do not include provisions for public dissemination of participant-level data. To protect participant confidentiality and comply with institutional and regulatory requirements, only aggregated study results will be made available through scientific publications and presentations.

08

Registry details

Key details

Study ID
NCT07847216
Lead sponsor
Fundació d'investigació Sanitària de les Illes Balears
Collaborators
Hospital Universitari de Bellvitge, Hospital Universitario La Fe, Hospital Universitario Marqués de Valdecilla, Hospital Universitari Vall d'Hebron Research Institute, Hospital General Universitario Gregorio Marañon, Hospital Universitario Ramon y Cajal, University Hospital of Girona Dr. Josep Trueta, Hospital General Universitario Reina Sofía de Murcia, Hospital del Mar, Hospital Son Espases, Hospital Álvaro Cunqueiro
Responsible party
Sebastian Jeri (MD, MSc, PhD, Fundació d'investigació Sanitària de les Illes Balears) — Principal investigator
First posted
Sep 29, 2026
Start date
Sep 1, 2026 (estimated)
Primary completion
Sep 30, 2029 (estimated)
Completion
Sep 30, 2031 (estimated)
Last update
Sep 29, 2026

Study contacts

Álvaro García-Granero, MD, PhD
Contact
alvaro.garciagranero@ssib.es
+34871205000
Sebastian Jeri, MD, PhD
Contact
sebastian.jeri@ssib.es
+34871205000

Oversight

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

Not currently enrolling

This study is not yet recruiting, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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