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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03222635
Registration number
NCT03222635
Ethics application status
Date submitted
17/07/2017
Date registered
19/07/2017
Titles & IDs
Public title
Prospective Endoscopic Follow-up of Patients With Submucosal and High Risk Mucosal Esophageal Adenocarcinoma
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Scientific title
Endoscopic Management of Patients With High Risk T1a and T1b N0M0 Esophageal Adenocarcinoma: a Prospective Multicenter Registry.
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Secondary ID [1]
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NL6116501817
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Universal Trial Number (UTN)
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Trial acronym
PREFER
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Submucosal Esophageal Adenocarcinoma
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Barrett Esophagus
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High-risk Mucosal Esophageal Adenocarcinoma
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Condition category
Condition code
Oral and Gastrointestinal
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Cancer
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Oesophageal (gullet)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Surgery - Endoscopic follow-up
Experimental: Endoscopic follow-up - Patients treated with endoscopic resection (ER) for a submucosal or high-risk mucosal esophageal adenocarcinoma without lymphnode- or distant metastases (N0M0) will undergo endoscopic follow-up.
Treatment: Surgery: Endoscopic follow-up
Endoscopic follow-up by means of regular upper endoscopies and endoscopic ultrasounds
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Intervention code [1]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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5-year disease-specific mortality/survival (descriptive statistics in SPSS, percentages, survival analysis)
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Assessment method [1]
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Disease specific mortality is decribed as mortality directly linked to the esophageal adenocarcinoma (i.e., metastasized EAC, metastasized disease with a simultaneously primary cancer present and it cannot be ruled out (based on histology) that the metastases are related to the other primary cancer, death due to complications of the endoscopic procedure, death due to complications after surgery or CRT, no clear cause of death in patients who have metastases or untreated local recurrence). If patients are diagnosed with distant metastases, and subsequently die of a non-tumor related cause, patients will still be documented as tumor-related death. Will be measured in number of patients and percentages. Survival analysis using Kaplan Meier will be performed.
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Timepoint [1]
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5 years
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Primary outcome [2]
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Overall survival (descriptive statistics in SPSS, percentages, survival analysis)
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Assessment method [2]
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Overall survival of study population (tumor-related + non-tumor-related deaths). Measured in numbers and percentages, survival analysis (KM).
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Timepoint [2]
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5 years
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Secondary outcome [1]
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Lymph node metastasis, confirmed by cytology and/or histology (descriptive statistics in SPSS, number of patients (%))
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Assessment method [1]
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Confirmed by cytology and/or histology by performing FNA during EUS or biopsies.
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Timepoint [1]
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5 years
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Secondary outcome [2]
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Local recurrence eligible for endoscopic therapy (descriptive statistics in SPSS, number of patients (%))
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Assessment method [2]
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In case a local recurrence is found during FU endoscopy, histopathology have to show if it is recurrent cancer.
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Timepoint [2]
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5 years
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Secondary outcome [3]
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Local recurrence requiring surgical therapy (descriptive statistics in SPSS, number of patients (%))
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Assessment method [3]
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In case a local cancer recurrence is not amendable for endoscopic re-treatment, for example due to extensive disease or fibrosis, a patient will be referred for surgery if possible.
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Timepoint [3]
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5 years
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Secondary outcome [4]
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Distant metastasis, histologically proven (descriptive statistics in SPSS, number of patients (%))
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Assessment method [4]
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Primary tumor of distant metastasis should be histopathologically evalueted by taking biopsies.
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Timepoint [4]
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5 years
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Secondary outcome [5]
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Quality of life during follow-up endoscopies (questionnaires)
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Assessment method [5]
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Quality of life is assessed by using questionnaires on set time points during the whole study.
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Timepoint [5]
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5 years
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Eligibility
Key inclusion criteria
* Patients with submucosal or high-risk mucosal EAC diagnosed in an ER specimen, by an expert gastrointestinal (GI) pathologists.
* Signed informed consent.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Prior history of high-risk mucosal or =T1sm.
* Synchronous esophageal squamous cell carcinoma.
* Suspicion on lymph node metastasis or distant metastasis on EUS, ultrasound of the neck or CT-thorax-abdomen performed six weeks after ER during baseline measurement.
* Tumor-positive deep resection margin (R1) in ER specimen.
* Patients unable to give signed informed consent.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
25/07/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
25/07/2028
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Actual
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Sample size
Target
225
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment hospital [1]
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Westmead hospital - Sydney
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Recruitment postcode(s) [1]
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- Sydney
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Recruitment outside Australia
Country [1]
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Belgium
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State/province [1]
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Brussels
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Country [2]
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Belgium
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State/province [2]
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Gent
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Country [3]
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Belgium
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State/province [3]
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Leuven
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Country [4]
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Belgium
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State/province [4]
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Roeselare
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Country [5]
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Germany
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State/province [5]
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Augsburg
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Country [6]
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Germany
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State/province [6]
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Duesseldorf
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Country [7]
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Germany
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State/province [7]
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Münich
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Country [8]
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Germany
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State/province [8]
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Regensburg
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Country [9]
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Netherlands
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State/province [9]
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Amsterdam
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Country [10]
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Netherlands
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State/province [10]
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Eindhoven
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Country [11]
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Netherlands
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State/province [11]
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Groningen
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Country [12]
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Netherlands
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State/province [12]
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Nieuwegein
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Country [13]
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Netherlands
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State/province [13]
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Nijmegen
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Country [14]
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Netherlands
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State/province [14]
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Rotterdam
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Country [15]
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Netherlands
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State/province [15]
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The Hague
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Country [16]
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Netherlands
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State/province [16]
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Zwolle
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Country [17]
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Switzerland
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State/province [17]
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Zürich
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Country [18]
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United Kingdom
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State/province [18]
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London
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Country [19]
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United Kingdom
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State/province [19]
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Nottingham
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Funding & Sponsors
Primary sponsor type
Other
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Name
Amsterdam UMC
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
Aim of this prospective multicenter study is to evaluate the safety of an endoscopic follow-up strategy in patients treated with endoscopic resection (ER) for submucosal or high-risk mucosal esophageal adenocarcinoma (T1bN0M0 or HR T1aN0M0 EAC).
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Trial website
https://clinicaltrials.gov/study/NCT03222635
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Trial related presentations / publications
Alvarez Herrero L, Pouw RE, van Vilsteren FG, ten Kate FJ, Visser M, van Berge Henegouwen MI, Weusten BL, Bergman JJ. Risk of lymph node metastasis associated with deeper invasion by early adenocarcinoma of the esophagus and cardia: study based on endoscopic resection specimens. Endoscopy. 2010 Dec;42(12):1030-6. doi: 10.1055/s-0030-1255858. Epub 2010 Oct 19. Scholvinck D, Kunzli H, Meijer S, Seldenrijk K, van Berge Henegouwen M, Bergman J, Weusten B. Management of patients with T1b esophageal adenocarcinoma: a retrospective cohort study on patient management and risk of metastatic disease. Surg Endosc. 2016 Sep;30(9):4102-13. doi: 10.1007/s00464-016-5071-y. Epub 2016 Jun 29. Erratum In: Surg Endosc. 2016 Sep;30(9):4114. doi: 10.1007/s00464-016-5147-8. Manner H, May A, Pech O, Gossner L, Rabenstein T, Gunter E, Vieth M, Stolte M, Ell C. Early Barrett's carcinoma with "low-risk" submucosal invasion: long-term results of endoscopic resection with a curative intent. Am J Gastroenterol. 2008 Oct;103(10):2589-97. doi: 10.1111/j.1572-0241.2008.02083.x. Epub 2008 Sep 10. Manner H, Pech O, Heldmann Y, May A, Pohl J, Behrens A, Gossner L, Stolte M, Vieth M, Ell C. Efficacy, safety, and long-term results of endoscopic treatment for early stage adenocarcinoma of the esophagus with low-risk sm1 invasion. Clin Gastroenterol Hepatol. 2013 Jun;11(6):630-5; quiz e45. doi: 10.1016/j.cgh.2012.12.040. Epub 2013 Jan 26. Manner H, Pech O, Heldmann Y, May A, Pauthner M, Lorenz D, Fisseler-Eckhoff A, Stolte M, Vieth M, Ell C. The frequency of lymph node metastasis in early-stage adenocarcinoma of the esophagus with incipient submucosal invasion (pT1b sm1) depending on histological risk patterns. Surg Endosc. 2015 Jul;29(7):1888-96. doi: 10.1007/s00464-014-3881-3. Epub 2014 Oct 8. Nieuwenhuis EA, van Munster SN, Meijer SL, Brosens LAA, Jansen M, Weusten BLAM, Alvarez Herrero L, Alkhalaf A, Schenk E, Schoon EJ, Curvers WL, Koch AD, van de Ven SEM, Verheij EPD, Nagengast WB, Westerhof J, Houben MHMG, Tang T, Bergman JJGHM, Pouw RE; Dutch Barrett Expert Centers. Analysis of metastases rates during follow-up after endoscopic resection of early "high-risk" esophageal adenocarcinoma. Gastrointest Endosc. 2022 Aug;96(2):237-247.e3. doi: 10.1016/j.gie.2022.03.005. Epub 2022 Mar 12.
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Public notes
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Contacts
Principal investigator
Name
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J. J. Bergman, MD, PhD
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Address
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Amsterdam UMC
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Vincent Bos, MD
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Address
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Country
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Phone
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+31204445500
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03222635