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Endometrial Cancer Lymphadenectomy Trial

Not Applicable
Recruiting
Conditions
Cancer of Endometrium Stage I
Cancer of Endometrium Stage II
Registration Number
NCT03438474
Lead Sponsor
Philipps University Marburg
Brief Summary

The primary aim of this trial is to ascertain whether or not systematic pelvic and para-aortic lymphadenectomy (LNE) does have a significant impact on overall survival (OS) in patients with endometrial cancer (EC) FIGO Stages I or II and high risk of recurrence. Secondary aims will be to evaluate the effect of LNE on disease free survival (DFS) and quality of life, as well as the complications and side effects of LNE and the number of resected lymphnodes. 640 patients with histologically confirmed EC with high risk of recurrence (stage pT1b - pT2, all histological subtypes; pT1a, G3 endometrioid or serous or clear cell EC or carcinosarcomas) will be randomized. In Arm A, a total hysterectomy and bilateral salpingo-oophorectomy and in case of serous or clear cell EC additionally an omentectomy will be performed. In arm B in addition a systematic pelvic and para-aortic LNE up to the level of the left renal vein will be performed.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
640
Inclusion Criteria
  1. histologically confirmed EC of clinical stages T1b and T2 (all histological types) and stage T1a G3 type 1 (endometrioid, endometriod with squamous differentiation, mucinous) or type 2 tumors (any percentage of serous or clear cell component) or carcinosarcoma
  2. a) no previous surgery concerning EC (primary surgery) or b) surgery after hysterectomy (e.g. for presumed low risk endometrial cancer) is allowed within 8 weeks after hysterectomy if no LNE was performed (secondary surgery)
  3. absence of bulky lymph nodes
  4. performance status ECOG 0-1
  5. age 18 - 75 years
  6. written informed consent
  7. adequate compliance
Exclusion Criteria
  1. stage pT1a, G1 or G2 tumors of type 1 histology
  2. sarcomas (except for carcinosarcoma = malignant mixed Müllerian tumor)
  3. EC of FIGO stages III or IV (except for microscopical lymph node metastases)
  4. evidence of extrauterine disease by visual inspection
  5. recurrent EC
  6. preceding chemo-, radio, or endocrine therapy for EC
  7. any concomitant disease not allowing surgery including lymphadenectomy and/or chemotherapy
  8. any medical history indicating excessive peri-operative risk
  9. any current medication containing considerable surgical risk (e.g. bleeding: due to oral anticoagulating agents)
  10. any known disorder or circumstances making participation in trial and follow-up questionable. Insufficient compliance is expected.
  11. patients with second malignancies if disease or treatment might have an impact on the patient's prognosis
  12. known HIV-infection or AIDS
  13. simultaneous participation in other clinical trials if not permitted by the steering committee (translational or QoL studies not interfering with the objectives of ECLAT are allowed)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Overall survival (OS)60 months

Impact of systematic pelvic and para-aortic lymphadenectomy (LNE) on overall survival in EC patients with high risk of recurrence

Secondary Outcome Measures
NameTimeMethod
Assessment of serious complicationsduring surgery, at hospital discharge, day 60, 6 months, 9 months, 12 months

Assessment of perioperative complications and site effects of LNE

Disease free survival (DFS)3 months, 6 months, 9 months, 12 months, 15 months, 18 months, 21 months, 24 months, 27 months, 30 months, 33 months, 36 months, 42 months, 48 months, 54 months, 60 months

Impact of systematic pelvic and para-aortic lymphadenectomy (LNE) on Disease free survival

Number of resected lymph nodesduring surgery

resected pelvic and para-aortic lymph nodes

Disease specific survival (DSS)3 months, 6 months, 9 months, 12 months, 15 months, 18 months, 21 months, 24 months, 27 months, 30 months, 33 months, 36 months, 42 months, 48 months, 54 months, 60 months

Impact of systematic pelvic and para-aortic lymphadenectomy (LNE) on Disease specific survival

EORTC QLQ-C30Baseline, at hospital discharge, 6 months, 9 months, 12 months, 15 months, 18 months, 21 months, 24 months, 27 months, 30 months, 33 months, 36 months, 42 months, 48 months, 54 months, 60 months

Health related Quality of life (QoL)

EORTC QLQ-EN24Baseline, at hospital discharge, 6 months, 9 months, 12 months, 15 months, 18 months, 21 months, 24 months, 27 months, 30 months, 33 months, 36 months, 42 months, 48 months, 54 months, 60 months

Health related Quality of life (QoL)

Trial Locations

Locations (61)

Ostalb-Klinikum Aalen, Frauenklinik

🇩🇪

Aalen, Germany

Klinikum St. Marien Amberg, Frauenklinik

🇩🇪

Amberg, Germany

Klinikum Ansbach, Klinikum Ansbach

🇩🇪

Ansbach, Germany

Universitätsklinikum Augsburg, Frauenklinik

🇩🇪

Augsburg, Germany

Hochtaunus-Kliniken gGmbH, Frauenklinik

🇩🇪

Bad Homburg, Germany

Sozialstiftung Bamberg, Klinikum am Bruderwald, Klinik für Frauenheilkunde

🇩🇪

Bamberg, Germany

SANA Klinikum Lichtenberg, Oskar-Ziehten-Krankenhaus, Frauenklinik

🇩🇪

Berlin, Germany

Vivantes Auguste-Viktoria-Klinikum, Klinik für Gynäkologie und Geburtsmedizin

🇩🇪

Berlin, Germany

Charité Campus Virchow-Klinikum, Klinik für Frauenheilkunde und Geburtshilfe

🇩🇪

Berlin, Germany

Vivantes Humboldt-Klinikum, Klinik für Gynäkologie und Geburtsmedizin

🇩🇪

Berlin, Germany

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Ostalb-Klinikum Aalen, Frauenklinik
🇩🇪Aalen, Germany
Karsten Gnauert, MD
Contact
0049 (0) 7361-551401
karsten.gnauert@kliniken-ostalb.de

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