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Trial Review
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Trial registered on ANZCTR
Registration number
ACTRN12623000320651
Ethics application status
Approved
Date submitted
22/02/2023
Date registered
25/03/2023
Date last updated
13/04/2024
Date data sharing statement initially provided
25/03/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
Outcomes in patients with early oesophageal cancer managed by non-surgical treatment.
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Scientific title
Outcomes in patients with high risk intramucosal cancer and superficial submucosal oesophageal adenocarcinoma managed initially with endoscopic local resection – a multi-centre retrospective study
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Secondary ID [1]
309058
0
None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
oesophageal cancer
329118
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Condition category
Condition code
Cancer
326090
326090
0
0
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Oesophageal (gullet)
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
Observational study in patients who have undergo endoscopic removal of early oesophageal cancers classified as high risk after removal.
As this is a retrospective review, there is no active participation and all data will be from medical records collected as part of routine clinical practice.
After endoscopic removal of a high risk early cancer, patients will be observed for any clinical, radiological or surgical evidence of recurrent/residual cancer. This information is routinely collected as part of routine clinical care and will simply be collated for analysis at the end of the study period.
This is a retrospective study and therefore participants will not be required to complete any questionnaires.
The intention is to observe outcomes more than 5 years after initial removal of the high risk cancer however all data will be collect regardless of follow-up interval.
All data will be retrospectively collected, however all centers have prospectively collected this data as part of routine clinical care in treatment databases.
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Intervention code [1]
325500
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Diagnosis / Prognosis
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
333955
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1. To assess the rates of cancer recurrence both locally, nodally or metastatic as a composite primary outcome.
This data will be sourced through review of medical records, imaging (CT/PET), endoscopic and surgical findings.
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Assessment method [1]
333955
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Timepoint [1]
333955
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It is aimed to collected a minimum of 5 years outcome data from the date of resection of the high risk cancer. In general patients are assessed 3 monthly for the first year, then 6 monthly and then annual to 5 years.
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Secondary outcome [1]
418827
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To determine patient survival and describe the cause(s) of death
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Assessment method [1]
418827
0
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Timepoint [1]
418827
0
5 years post resection of high risk cancer. Outcome will be determined at last follow-up as recorded in the patients medical records.
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Secondary outcome [2]
418828
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To describe surgical mortality in surgical candidates
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Assessment method [2]
418828
0
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Timepoint [2]
418828
0
30 days post surgery
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Secondary outcome [3]
418829
0
To describe the use of adjuvant chemotherapy/radiotherapy post endoscope local resection (ELR) / surgery. This data will be sourced from medical records.
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Assessment method [3]
418829
0
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Timepoint [3]
418829
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5 years post resection of high risk cancer. Outcome will be determined at last follow-up as recorded in the patients medical records.
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Secondary outcome [4]
418830
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To describe the method of ELR, including Endoscopic Mucosal Resection (EMR), Endoscopic Submucosal Dissection (ESD). This data will be sourced for treatment databases and patient medical records.
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Assessment method [4]
418830
0
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Timepoint [4]
418830
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5 years post resection of high risk cancer.
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Secondary outcome [5]
418831
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To determine cancer-free survival
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Assessment method [5]
418831
0
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Timepoint [5]
418831
0
5 years post resection of high risk cancer.
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Secondary outcome [6]
419822
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To describe surgical morbidity in surgical candidates
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Assessment method [6]
419822
0
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Timepoint [6]
419822
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5 years post surgical management.
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Eligibility
Key inclusion criteria
All patients greater than or equal to 18 years-old, with a diagnosis of high risk T1a (HR-IMC) and T1b Oesophageal Adenocarcinoma (OAC) on ELR specimens.
(T1a and T1b is not an acronym but rather a T stage so this can't be written out)
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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
• Age < 18 years;
• Prior surgery for oesophageal cancer
• Known Lymph node or distant metastasis seen on baseline staging EUS, CT or PET
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
A sample of 200 participants’ data (approximately 20 at each site) will be reviewed for this descriptive study.
Patients will be stratified according to histopathological grading (T1a/T1b disease or AJCC staging) and treatment (ELR vs surgical) status. Descriptive summaries of patient cohort demographic and clinical data will consist of frequency distributions (n, %) for categorical data and means and standard deviations or medians and interquartile ranges for continuous data, depending on data distribution. Incidences of cancer recurrence (local, nodal or metastatic) and mortality outcomes (overall and disease-free survival) over the study period will be described using frequency distributions. Time to event survival outcomes (recurrence and mortality) will be examined using Kaplan-Meier survival probabilities and summarised using medians and 95% confidence intervals (CIs).
Stata version 17.0 (StataCorp, College Station, TX) will be used for data analysis and significance (alpha) will be set at 0.05.
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
31/03/2023
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Actual
30/10/2023
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Date of last participant enrolment
Anticipated
31/03/2025
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
200
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Accrual to date
82
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,WA,VIC
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Recruitment hospital [1]
24089
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Lyell McEwin Hospital - Elizabeth Vale
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Recruitment hospital [2]
24090
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Royal Brisbane & Womens Hospital - Herston
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Recruitment hospital [3]
24091
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The Royal Adelaide Hospital - Adelaide
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Recruitment hospital [4]
24092
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St Vincent's Hospital Brisbane - Kangaroo Point
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Recruitment hospital [5]
24093
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The Wesley Hospital - Auchenflower
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Recruitment hospital [6]
24094
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Western Hospital - Footscray - Footscray
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Recruitment hospital [7]
24095
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [8]
24096
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Royal Perth Hospital - Perth
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Recruitment hospital [9]
24097
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Fiona Stanley Hospital - Murdoch
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Recruitment hospital [10]
24098
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment hospital [11]
24099
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Melbourne Endoscopy Monash Day Procedure Centre - Clayton
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Recruitment postcode(s) [1]
39597
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5112 - Elizabeth Vale
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Recruitment postcode(s) [2]
39598
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4029 - Herston
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Recruitment postcode(s) [3]
39599
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5000 - Adelaide
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Recruitment postcode(s) [4]
39600
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4169 - Kangaroo Point
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Recruitment postcode(s) [5]
39601
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4066 - Auchenflower
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Recruitment postcode(s) [6]
39602
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3011 - Footscray
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Recruitment postcode(s) [7]
39603
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4102 - Woolloongabba
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Recruitment postcode(s) [8]
39604
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6000 - Perth
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Recruitment postcode(s) [9]
39605
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6150 - Murdoch
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Recruitment postcode(s) [10]
39606
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6009 - Nedlands
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Recruitment postcode(s) [11]
39607
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3168 - Clayton
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Recruitment outside Australia
Country [1]
25281
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New Zealand
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State/province [1]
25281
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Middlemore
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Funding & Sponsors
Funding source category [1]
313262
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Government body
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Name [1]
313262
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WA Cancer Network
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Address [1]
313262
0
North Metro Health Service, Verdun Street, NEDLANDS WA 6009
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Country [1]
313262
0
Australia
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Funding source category [2]
313263
0
Commercial sector/Industry
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Name [2]
313263
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Olympus Medical
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Address [2]
313263
0
3 Acacia Place, Notting Hill, Victoria 3168, Australia
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Country [2]
313263
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Australia
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Primary sponsor type
Government body
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Name
WA Cancer Network
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Address
North Metro Health Service, Verdun Street, NEDLANDS WA 6009
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Country
Australia
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Secondary sponsor category [1]
314996
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Commercial sector/Industry
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Name [1]
314996
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Olympus Medical
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Address [1]
314996
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3 Acacia Place, Notting Hill, Victoria 3168, Australia
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Country [1]
314996
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
312493
0
Sir Charles Gairdner Osborne Park Health Care Group (SCGOPHCG) - Scientific Review Subcommittee
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Ethics committee address [1]
312493
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2nd Floor A Block Hospital Avenue NEDLANDS Western Australia 6009
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Ethics committee country [1]
312493
0
Australia
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Date submitted for ethics approval [1]
312493
0
12/11/2022
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Approval date [1]
312493
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05/12/2022
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Ethics approval number [1]
312493
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RGS0000005710
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Summary
Brief summary
Contemporary treatment of early oesophageal (food pipe) cancer, involves minimally invasive endoscopic procedures; while surgery is reserved only for cases with the highest-risk of the cancer spreading into the surrounding tissues. The risk of cancer spread is determined by samples removed at endoscopy, in which a pathologist is looking to see the depth of cancer spread into the wall of the oesophagus or for abnormal characteristics of the cancer. The purpose of this study is to try and identify patients who are considered higher risk by conventional practice, who are actually at low risk for cancer spread; and, thus can forgo the need for a major operation with poor post-operative outcomes with respect to quality of life, morbidity and mortality. Who is it for? You may be eligible for this study if you are aged 18 years or older and you have been diagnosed with a high risk oesophageal cancer removed at endoscopy. Study details This observational study will be reviewing the medical records of patients who meet the inclusion criteria only. Participants who meet the inclusion criteria will not be required to attend any additional clinic visits or complete assessments; all relevant information will be extracted from medical records directly. It is hoped this research will determine which patients, with lower risk of cancer spread would be considered candidates for non-surgical management, to avoid an unnecessary (major) oesophageal operation.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
124858
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A/Prof Spiro Raftopoulos
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Address
124858
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Sir Charles Gairdner Hospital
Hospital Avenue
NEDLANDS WA 6009
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Country
124858
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Australia
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Phone
124858
0
+61 8 64570112
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Fax
124858
0
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Email
124858
0
[email protected]
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Contact person for public queries
Name
124859
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Spiro Raftopoulos
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Address
124859
0
Sir Charles Gairdner Hospital
Hospital Avenue
NEDLANDS WA 6009
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Country
124859
0
Australia
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Phone
124859
0
+61 8 64570112
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Fax
124859
0
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Email
124859
0
[email protected]
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Contact person for scientific queries
Name
124860
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Spiro Raftopoulos
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Address
124860
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Sir Charles Gairdner Hospital
Hospital Avenue
NEDLANDS WA 6009
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Country
124860
0
Australia
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Phone
124860
0
+61 8 64570112
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Fax
124860
0
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Email
124860
0
[email protected]
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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
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
18405
Study protocol
385450-(Uploaded-22-02-2023-00-18-55)-Study-related document.pdf
18407
Ethical approval
385450-(Uploaded-22-02-2023-00-19-40)-Study-related document.pdf
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF