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Feasibility Study of Sentinel Navigation Surgery in Early Gastric Cancer Using Fluorescence (SENORITA4)

Not Applicable
Not yet recruiting
Conditions
Early Gastric Cancer
Interventions
Procedure: Laparoscopic sentinel navigation surgery using fluorescence
Registration Number
NCT05978882
Lead Sponsor
National Cancer Center, Korea
Brief Summary

SENORITA 1 trial showed laparoscopic sentinel lymph node biopsy and stomach preserving surgery in early gastric cancer can increase the quality of life. (Ryu KW et al. JCO 2022) The radioactive isotope is difficult to use because of the hazard of radiation and shortage of materials. The aim of this study is to investigate whether laparoscopic sentinel lymph node biopsy and stomach-preserving surgery using only fluorescence is feasible.

Detailed Description

1. Injection of Indocyanine Green (ICG)

* Endoscopic injection of 0.25mg/ml of ICG on 4 sites around gastric cancer

* Identification of sentinel basin using fluorescence laparoscopy

* Laparoscopic sentinel basin dissection and identification of sentinel node at the back table

2. Surgical considerations

* Conventional gastrectomy is performed if positive sentinel nodes are diagnosed in the frozen section.

* If micrometastasis or isolated tumor cells in sentinel basin lymph nodes were diagnosed in permanent pathology, re-operation of conventional gastrectomy is not performed.

* However, re-operation of conventional gastrectomy should be performed in case of macrometastasis, deep and lateral margin positive, more than pT2 lesion in the permanent pathology.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
203
Inclusion Criteria
  • single lesion of adenocarcinoma in preoperative endoscopic biopsy clinical stage T1N0 in the preoperative evaluation of endoscopy and computed tomography
  • tumor size: less than 3cm
  • location: 2cm far from the pylorus or cardia
  • aged 20 to 80
  • ECOG 0 or 1
  • patient who signed the agreement
  • patient who is suspected to underwent laparoscopic or robotic gastrectomy
Exclusion Criteria
  • indication of endoscopic submucosal resection
  • inoperable due to poor cardiac, and pulmonary function
  • pregnant
  • having allergic reaction, previous upper abdominal surgery except laparoscopic cholecystectomy, previous radiation therapy to upper abdomen
  • diagnosed as malignancy within 5 years except carcinoma in situ of cervix cancer and thyroid cancer

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Laparoscopic sentinel navigation surgeryLaparoscopic sentinel navigation surgery using fluorescencecompare the detection rate of sentinel lymph nodes to that of previous study (SENORITA1 trial)
Primary Outcome Measures
NameTimeMethod
Detection rate of Sentinel lymph nodes15 days after operation

number of patients whose sentinel nodes are detected / enrolled number of patients \*100

Secondary Outcome Measures
NameTimeMethod
3 year overall survival rate3 year after surgery

A total of enrollment period is suspected to be three years and patients will be followed up for five years.

3 year recurrence free survival rate3 year after surgery

A total of enrollment period is suspected to be three years and patients will be followed up for five years.

scores of global health status scale, functional scales, and symptom scales/items of the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30 and STO225 years

Survey for quality of life will be performed regularly for three years after surgery. Measurement tool is the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30 and STO22. In EORTC QLQ C30, there are 1 global health status scale, 5 functional scales, and 9 symptom scales/items. EORTC QLQ STO22 includes 5 symptom scales and 4 single items. Each scale and item ranges 0 to 100. Higher score of global health status and functinoal scales indicate better quality of life and lower score of symptom scales indicates better quality of life. There is no summed score in these questionnaires.

5 year disease specific death rate5 years

A total of enrollment period is suspected to be three years and patients will be followed up for five years. Therefore, we can complete data collection at five year later from when the last enrolled patients underwent intervention

3 year disease free survival3 year after surgery

A total of enrollment period is suspected to be three years and patients will be followed up for five years.

3 year disease specific death rate3 year after surgery

A total of enrollment period is suspected to be three years and patients will be followed up for five years.

5 year overall survival rate5 years

A total of enrollment period is suspected to be three years and patients will be followed up for five years. Therefore, we can complete data collection at five year later from when the last enrolled patients underwent intervention

5 year disease free survival rate5 years

A total of enrollment period is suspected to be three years and patients will be followed up for five years. Therefore, we can complete data collection at five year later from when the last enrolled patients underwent intervention

5 year recurrence free survival rate5 years

A total of enrollment period is suspected to be three years and patients will be followed up for five years. Therefore, we can complete data collection at five year later from when the last enrolled patients underwent intervention

Trial Locations

Locations (7)

Dongnam Inst. of Radiological & Medical Science

🇰🇷

Busan, Gijang-gun, Korea, Republic of

Gyeongsang National University Hospital

🇰🇷

Gyeongsang, Gingu-si, Korea, Republic of

Sevrance Hospital

🇰🇷

Seoul, Sinchon, Korea, Republic of

Gyeongsang National University Changwon Hospital

🇰🇷

Changwon, Korea, Republic of

Soon Chun Hyang University Hospital Bucheon

🇰🇷

Seoul, Korea, Republic of

Samsung Medical Center

🇰🇷

Seoul, Korea, Republic of

Ajou University Medical Center

🇰🇷

Gyeonggi-do, Suwon-si, Korea, Republic of

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