RECRUITING

Sentinel Node Biopsy in Endometrial Cancer

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

Endometrial cancer (EC) is the most common gynaecological cancer. Current treatment of EC typically includes removal of the uterus and to determine the extent of the disease (removal of fallopian tubes, ovaries \& if required a lymph node dissection (surgical staging)). While lymph node dissection may be valuable to guide the need for adjuvant treatment (chemo or radiotherapy) after surgery, it has been a topic of controversy for the last 30 years. In some patients it causes morbidity, specifically lymphoedema. This recently has been replaced with sentinel node biopsy (SNB). It requires an injection of a dye into the cervix with specific equipment \& surgical dissection of the lymph node in which the dye first becomes visible. Despite this promising proposition \& similar to a lymph node dissection, the value to patients, cost effectiveness \& potential harms (e.g. lymphedema) of SNB compared to no-node dissection in EC has never been established. Aim: determine the value of SNB for patients, the healthcare system and exclude detriment to patients using a randomised approach 1:1. Stage 1 - 444 patients. Stage 2 additional 316 patients. Primary Outcome Stage 1: Proportion of participants returning to usual daily activities at 12 months from surgery using the EQ-5D which will determine when women in both groups can return to their usual activities. Primary Outcome Stage 2: Treatment non-inferiority as evaluated by disease-free survival status at 4.5 years post-surgery, as measured by the time interval between the date of randomisation and date of first recurrence. Confirmation of recurrent disease will be ascertained through clinical assessment, radiological work-up and/or histological results.

Official Title

A Phase III Randomised Clinical Trial Comparing Sentinel Node Biopsy With No Retroperitoneal Node Dissection in Apparent Early-Stage Endometrial Cancer

Quick Facts

Study Start:2021-01-18
Study Completion:2031-01
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT04073706

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years
Sexes Eligible for Study:FEMALE
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. 1. Females, over 18 years, with histologically confirmed primary epithelial cancer of the endometrium of any cell type or uterine carcinosarcoma (mixed malignant mullerian tumour);
  2. 2. Clinically stage I disease (disease confined to body of uterus);
  3. 3. Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
  4. 4. Signed written informed consent;
  5. 5. Participant must meet criteria for a laparoscopic or robotic surgical approach as determined by the treating physician (e.g. suitable for TH BSO, ability to tolerate Trendelenberg positioning)
  6. 6. All available clinical evidence (physical examination findings, or medical imaging such as CT, MRI or ultrasound) demonstrates no evidence of extrauterine disease
  7. 7. Myometrial Invasion on MRI of not more than 50%. (Only if participant is \<45yo, has ONLY Grade 1 EAC and wishes to retain their ovaries).
  8. 8. Negative (serum or urine) pregnancy test ≤ 30 days of surgery in pre-menopausal women and women \< 2 years after the onset of menopause.
  1. 1. Evidence of extrauterine disease (apparent involvement of cervix, vagina, parametria, adnexa, lymph nodes, bladder, bowel or distant sites) by clinical examination and/or through medical imaging.
  2. 2. Enlarged retroperitoneal pelvic and/or aortic lymph nodes (\>1 cm) on medical imaging;
  3. 3. Estimated life expectancy of less than 6 months;
  4. 4. Patients who have absolute contraindications for adjuvant radiotherapy and/or chemotherapy;
  5. 5. Patients who have previously received radiation treatment to the pelvis
  6. 6. Serious concomitant systemic disorders incompatible with the study (at the discretion of the investigator);
  7. 7. Patient compliance and geographic proximity that do not allow adequate follow-up;
  8. 8. Patients with allergy to Indocyanine Green (ICG)
  9. 9. Patients who have had previous retroperitoneal surgery
  10. 10. Patients who require a retroperitoneal (pelvic +/- para-aortic) lymph node dissection (lymphadenectomy)
  11. 11. Other prior malignancies \<5 years before inclusion, except for successfully treated keratinocyte skin cancers, or ductal carcinoma of the breast insitu
  12. 12. Uterine perforation during endometrial tissue sampling

Contacts and Locations

Study Contact

Vanessa Behan, BSN
CONTACT
+61 7 3346 5590
endo3trial@uq.edu.au
Sara Baniahmadi
CONTACT
+61733465073
sara.baniahmadi@health.qld.gov.au

Principal Investigator

Andreas Obermiar, MD
STUDY_CHAIR
Director, Queensland Centre for Gynaecological Cancer Research

Study Locations (Sites)

Houston Methodist Hospital
Houston, Texas, 77030
United States

Collaborators and Investigators

Sponsor: Queensland Centre for Gynaecological Cancer

  • Andreas Obermiar, MD, STUDY_CHAIR, Director, Queensland Centre for Gynaecological Cancer Research

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2021-01-18
Study Completion Date2031-01

Study Record Updates

Study Start Date2021-01-18
Study Completion Date2031-01

Terms related to this study

Keywords Provided by Researchers

  • uterine cancer
  • sentinel node biopsy

Additional Relevant MeSH Terms

  • Endometrial Cancer Stage I
  • Sentinel Lymph Node
  • Surgery