625 Participants Needed

Nodal Sampling for Endometrial Cancer

RM
Overseen ByRachel Miller
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines two methods for checking lymph nodes during surgery for endometrial cancer, which affects the uterine lining. The goal is to determine which method helps patients remain cancer-free longer after surgery. One group will undergo a selective surgical staging procedure, while the other will have a sentinel node procedure. Women who may qualify have endometrial cancer confined to the uterus and are scheduled for a specific type of surgery.

As an unphased trial, this study allows participants to contribute to important research that could enhance surgical outcomes for future patients.

Will I have to stop taking my current medications?

The trial protocol does not specify whether you need to stop taking your current medications. However, if you are on chemotherapy, hormone therapy, or immunotherapy for your endometrial cancer, you cannot participate in the trial.

What prior data suggests that these surgical staging methods are safe for endometrial cancer patients?

Research has shown that selective surgical staging for endometrial cancer is generally well-tolerated. Studies comparing surgical outcomes indicate a low risk of serious complications. For instance, one study found that in early-stage endometrial cancer, positive outcomes were common, with negative events occurring in only about 1.56% of cases, indicating that serious adverse events are rare.

Moreover, another study discovered that survival rates, both disease-free and overall, are similar when comparing selective surgical staging with other methods. This supports the idea that the safety of selective surgical staging is comparable to other approaches.

Overall, these findings suggest that selective surgical staging is a safe option for patients with endometrial cancer, with very few reports of serious side effects.12345

Why are researchers excited about this trial?

Researchers are excited about the nodal sampling method for endometrial cancer because it aims to improve surgical precision and potentially reduce unnecessary procedures. Unlike traditional methods that might involve removing numerous lymph nodes, this approach uses selective surgical staging with side-specific lymphadenectomy, allowing for a more targeted removal based on intraoperative consultation between the pathologist and surgeon. This could lead to fewer complications and quicker recovery times for patients. Additionally, the incorporation of a sentinel node procedure as a comparator might provide further insights into the most effective way to stage and treat endometrial cancer.

What evidence suggests that this trial's treatments could be effective for endometrial cancer?

This trial will compare two approaches for nodal sampling in endometrial cancer: Selective Surgical Staging with side-specific lymphadenectomy (LAD) and the REFLEX side-specific LAD. Research has shown that carefully selecting surgeries can benefit some women with endometrial cancer. One study found that removing both pelvic and para-aortic lymph nodes increased 5-year survival rates by 10.6%. This suggests that checking and removing certain lymph nodes might help control cancer spread. However, other research indicates no significant difference in overall survival when comparing a smaller lymph node test, called a sentinel lymph node biopsy, to removing all lymph nodes. The trial aims to find the best method for checking lymph nodes during surgery while weighing the risks and benefits.24678

Who Is on the Research Team?

Rachel Ware Miller, MD | UK Healthcare

Rachel Miller, M.D.

Principal Investigator

University of Kentucky

Are You a Good Fit for This Trial?

This trial is for women with endometrial cancer confined to the uterus, who can undergo surgery and have a life expectancy of at least 6 months. They should understand the study and consent to participate. Prior chemotherapy is okay if it was over five years ago with no current disease. Women must not be pregnant, have had prior pelvic lymphadenectomy or irradiation, or severe allergies to iodine/ICG.

Inclusion Criteria

AST(SGOT)/ALT(SGPT) < 3.0X upper limit of normal
Ability to understand and the willingness to sign a written informed consent document
Life expectancy (estimated survival) of at least 6 months
See 4 more

Exclusion Criteria

GOG Performance Status greater than 2 (Appendix II)
Patients with psychiatric illness/social situations that would limit compliance with study requirements
I do not have another cancer that could affect this treatment's safety or results.
See 8 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Surgical Staging

Participants undergo selective surgical staging or sentinel node procedure for lymph node evaluation

1 day
1 visit (in-person)

Follow-up

Participants are monitored for recurrence-free survival, progression-free survival, and overall survival

up to 5 years

What Are the Treatments Tested in This Trial?

Interventions

  • REFLEX
  • Selective surgical staging
Trial Overview The study compares two surgical methods for checking lymph nodes in endometrial cancer: selective surgical staging versus sentinel node REFLEX method. It aims to find out which method is better for predicting cancer recurrence after surgery by monitoring recurrence-free survival rates.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Active Control
Group I: Selective Surgical Staging with side-specific lymphadenectomy (LAD)Experimental Treatment1 Intervention
Group II: REFLEX side-specific LADActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Rachel Miller

Lead Sponsor

Trials
5
Recruited
770+

Published Research Related to This Trial

A systematic review of 45 studies involving 12,459 patients found only moderate agreement (67%) between preoperative endometrial sampling and final tumor grade diagnosis, indicating potential discrepancies in cancer grading.
Hysteroscopic biopsy showed the highest agreement rate (89%) with final diagnoses compared to other sampling methods, while the lowest agreement was observed for grade 2 carcinomas, highlighting the need for careful interpretation of preoperative results.
Accuracy of Endometrial Sampling in Endometrial Carcinoma: A Systematic Review and Meta-analysis.Visser, NCM., Reijnen, C., Massuger, LFAG., et al.[2022]

Citations

The Role of Lymphadenectomy in Surgical Staging ...A 10.6% increase in 5-year overall survival was noted in intermediate to high-risk patients undergoing both pelvic and para-aortic lymphadenectomies. Lymph node ...
The impact of lymphadenectomy on cancerspecific survival ...First, the overall positive outcome event rate in early-stage endometrial cancer is very low (only 1.56% in our study). Specifically, in ...
Selective Surgical Staging versus Reflex ...This phase III trial compares the effectiveness of selective surgical staging versus reflex side specific lymphadenectomy (LAD) in evaluating sentinel lymph ...
Long-term outcomes in patients with endometrial cancer ...Results: 13 studies were included, involving 36621 EC patients. No difference was revealed in OS between SLNB and LND (HR=1.04, 95%CI: 0.80–1.33 ...
Clinical trial A prospective multicenter international single- ...This prospective multicenter observational study aims to assess whether pelvic/non-vaginal recurrence rates are comparable to historical data in patients with ...
Long-term outcomes in patients with endometrial cancer ...This study aimed to assess the prognosis of endometrial cancer (EC) patients after sentinel lymph node biopsy (SLNB) or lymph node dissection (LND) alone.
Long-term survival outcomes in high-risk endometrial ...Disease-free survival (85.2% vs 82.8%; p=0.74) and overall survival (91.3% vs 92.6%; p=0.62) were not different between the sentinel lymph node alone and ...
Comparing Surgical and Oncological Outcomes between ...In conclusion, our study findings suggest that ICG SLN mapping is an acceptable and safe alternative to routine lymphadenectomy in the surgical ...
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