Detection of Sentinel Lymph Nodes in Patients With Endometrial Cancer Undergoing Robotic-Assisted Staging: Comparison of Isosulfan Blue and Indocyanine Green Dyes With Fluorescence Imaging
Overview
- Phase
- Not Applicable
- Intervention
- sentinel lymph node detection
- Conditions
- Endometrial Cancer
- Sponsor
- Ohio State University Comprehensive Cancer Center
- Enrollment
- 204
- Locations
- 2
- Primary Endpoint
- Negative Predictive Value of Sentinel Lymph Node Prediction of Metastatic Disease
- Status
- Completed
- Last Updated
- 3 years ago
Overview
Brief Summary
This clinical trial studies lymph node mapping in patients with endometrial cancer. Lymph node mapping may allow for limited removal of lymph nodes in as part of endometrial cancer staging and treatment.
Detailed Description
PRIMARY OBJECTIVE: I. To estimate the negative predictive value of pelvic sentinel lymph node (SLN) in endometrial cancer to predict nodal metastasis. SECONDARY OBJECTIVE: II. To examine the ability of sentinel lymph nodes to increase the detection of metastatic disease through ultra-sectioning and immuno-histochemical (IHC) staining by comparing IHC results and standard hematoxylin and eosin (H\&E) results. OUTLINE: Patients undergo sentinel lymph node detection using fluorescence imaging with indocyanine green solution and isosulfan blue and sentinel lymph node biopsy and detection of sentinel lymph nodes is noted in the within 30 minutes of injection of the dye, followed by full pelvic lymph node dissection and aortic lymph node dissection as indicated, and standard hysterectomy and salpingo-oophorectomy. After completion of study treatment, patients are followed up every 3 months for 2 years, every 6 months for 3 years for a total of 5 years according to the standard surveillance guidelines for endometrial cancer.
Investigators
Floor Backes
Principal Investigator
Ohio State University Comprehensive Cancer Center
Eligibility Criteria
Inclusion Criteria
- •The patient must be willing and able to provide informed consent
- •The patient is willing and able to comply with the study protocol
- •The patient has endometrial cancer and is scheduled for robotic hysterectomy and lymphadenectomy
- •The patient agrees to follow-up examinations out to 5-years post-treatment
Exclusion Criteria
- •The patient is not a candidate for robotic assisted hysterectomy and lymphadenectomy
- •The patient has known or suspected allergies to iodine, indocyanine green (ICG) or isosulfan blue (ISB)
- •The patient has hepatic dysfunction confirmed by bilirubin \> 2 x normal (based on reference values from the laboratory used by the patient)
Arms & Interventions
sentinel lymph node detection
Patients undergo sentinel lymph node detection using fluorescence imaging with indocyanine green solution and isosulfan blue and sentinel lymph node biopsy.
Intervention: sentinel lymph node detection
sentinel lymph node detection
Patients undergo sentinel lymph node detection using fluorescence imaging with indocyanine green solution and isosulfan blue and sentinel lymph node biopsy.
Intervention: indocyanine green solution
sentinel lymph node detection
Patients undergo sentinel lymph node detection using fluorescence imaging with indocyanine green solution and isosulfan blue and sentinel lymph node biopsy.
Intervention: isosulfan blue
sentinel lymph node detection
Patients undergo sentinel lymph node detection using fluorescence imaging with indocyanine green solution and isosulfan blue and sentinel lymph node biopsy.
Intervention: sentinel lymph node biopsy
Outcomes
Primary Outcomes
Negative Predictive Value of Sentinel Lymph Node Prediction of Metastatic Disease
Time Frame: average of 1-14 days after the procedure when final pathologic evaluation has been completed
NPV is found by dividing the number of true negatives by the number of all patients without pelvic lymph node metastases. Exact 95% confidence intervals (CIs) for the proportions will be calculated.
Secondary Outcomes
- Percentage of Metastatic Cases Found Using Ultra-sectioning and IHC Staining(average of 1-14 days after the procedure when final pathologic evalulation has been completed)