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Intraoperative Pathological Evaluation for Surgical Treatment & Staging for Endometrial Cancer

Primary Purpose

Endometrial Cancer

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Lymphadenectomy
Sponsored by
Frederick R. Ueland, M.D.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Endometrial Cancer focused on measuring Endometrial, Cancer, Intraoperative Consultation

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • All patients must be surgical candidates for complete hysterectomy and bilateral salpingo-oophorectomy and pelvic and aortic lymphadenectomy.
  • Patients must have a histologically confirmed diagnosis of endometrial cancer and no clinical evidence of extra-uterine disease on preoperative evaluation.
  • Preoperative evaluation to rule-out extra-uterine disease may include CT scan, MRI, or ultrasound. Preoperative imaging is not mandatory for study enrollment.
  • Patients may have received prior systemic chemotherapy. Such therapy must have been completed at least 5 years prior to study entry and the patient has no evidence of disease subsequent to such therapy. Patients must not have received neoadjuvant chemotherapy for the present disease.
  • Patients must have GOG performance status 0, 1, or 2.
  • Patients must have an estimated survival greater than or equal to 3 months
  • Patients who have met the pre-entry requirements specified in Section 7.0.
  • Patients must have signed an approved informed consent and HIPAA authorization.

Exclusion Criteria:

  • Patients with clinical evidence of disease beyond the uterus, including presence of suspicious aortic or inguinal nodes on imaging or clinical exam.
  • Patients who have received previous vaginal, pelvic, or abdominal irradiation.
  • Patients who received chemotherapy directed at the present disease.
  • Patients who have circumstances that will not permit completion of this study or the required follow-up.
  • Patients with renal abnormalities, such as pelvic kidney, horseshoe kidney, or renal transplantation, that would require modification of surgical lymph node assessments.
  • Patients with a history of other invasive malignancies, with the exception of non-melanoma skin cancer within the last five years.
  • Patients with GOG Performance Grade of 3 or 4.

Sites / Locations

  • University of Kentucky Markey Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

Low-risk for nodal involvement

High-risk for nodal involvement

Arm Description

No lymphadenectomy recommended

Lymphadenectomy recommended, including: obturator, iliac (internal, external, common) and aortic lymph nodes

Outcomes

Primary Outcome Measures

Recurrence-free survival
Recurrence-free survival rates in low-risk and high-risk subgroups of patients with endometrial cancer as classified by the use of pathology intraoperative consultation (IOC).

Secondary Outcome Measures

Full Information

First Posted
January 13, 2012
Last Updated
November 15, 2021
Sponsor
Frederick R. Ueland, M.D.
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1. Study Identification

Unique Protocol Identification Number
NCT01512810
Brief Title
Intraoperative Pathological Evaluation for Surgical Treatment & Staging for Endometrial Cancer
Official Title
Treatment of Endometrial Cancer Utilizing Pathology Intraoperative Consultation to Determine Extent of Surgical Staging
Study Type
Interventional

2. Study Status

Record Verification Date
November 2021
Overall Recruitment Status
Completed
Study Start Date
January 2012 (Actual)
Primary Completion Date
August 26, 2021 (Actual)
Study Completion Date
August 26, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Frederick R. Ueland, M.D.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Complete pelvic and para-aortic lymphadenectomy performed at the time of primary surgical staging for endometrial cancer increases operative time and surgical morbidity, but appears to be necessary in most high grade and deeply invasive cancers. To date, the Mayo Clinic approach has not been reproduced, and the investigators propose to validate their algorithm at the University of Kentucky utilizing intra-operative consultation (IOC). The preliminary data at the University of Kentucky for IOC and endometrial cancer outcomes suggest that the investigators are well-suited to perform this investigation. A surgical approach that is tailored to the patient's cancer biology is rational, supported by the recent literature, and medically compelling since the co-morbidities of many obese, low-risk EC patients put them at significantly increased perioperative risk for complete lymphadenectomy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Endometrial Cancer
Keywords
Endometrial, Cancer, Intraoperative Consultation

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
200 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Low-risk for nodal involvement
Arm Type
No Intervention
Arm Description
No lymphadenectomy recommended
Arm Title
High-risk for nodal involvement
Arm Type
Experimental
Arm Description
Lymphadenectomy recommended, including: obturator, iliac (internal, external, common) and aortic lymph nodes
Intervention Type
Procedure
Intervention Name(s)
Lymphadenectomy
Intervention Description
Lymphadenectomy recommended, including: obturator, iliac (internal, external, common) and aortic lymph nodes
Primary Outcome Measure Information:
Title
Recurrence-free survival
Description
Recurrence-free survival rates in low-risk and high-risk subgroups of patients with endometrial cancer as classified by the use of pathology intraoperative consultation (IOC).
Time Frame
24 months

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All patients must be surgical candidates for complete hysterectomy and bilateral salpingo-oophorectomy and pelvic and aortic lymphadenectomy. Patients must have a histologically confirmed diagnosis of endometrial cancer and no clinical evidence of extra-uterine disease on preoperative evaluation. Preoperative evaluation to rule-out extra-uterine disease may include CT scan, MRI, or ultrasound. Preoperative imaging is not mandatory for study enrollment. Patients may have received prior systemic chemotherapy. Such therapy must have been completed at least 5 years prior to study entry and the patient has no evidence of disease subsequent to such therapy. Patients must not have received neoadjuvant chemotherapy for the present disease. Patients must have GOG performance status 0, 1, or 2. Patients must have an estimated survival greater than or equal to 3 months Patients who have met the pre-entry requirements specified in Section 7.0. Patients must have signed an approved informed consent and HIPAA authorization. Exclusion Criteria: Patients with clinical evidence of disease beyond the uterus, including presence of suspicious aortic or inguinal nodes on imaging or clinical exam. Patients who have received previous vaginal, pelvic, or abdominal irradiation. Patients who received chemotherapy directed at the present disease. Patients who have circumstances that will not permit completion of this study or the required follow-up. Patients with renal abnormalities, such as pelvic kidney, horseshoe kidney, or renal transplantation, that would require modification of surgical lymph node assessments. Patients with a history of other invasive malignancies, with the exception of non-melanoma skin cancer within the last five years. Patients with GOG Performance Grade of 3 or 4.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Frederick Ueland, M.D.
Organizational Affiliation
Lucille P. Markey Cancer Center at University of Kentucky
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Kentucky Markey Cancer Center
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40536
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Intraoperative Pathological Evaluation for Surgical Treatment & Staging for Endometrial Cancer

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