A Trial Of Lymphatic Mapping And Sentinel Node Lymphadenectomy For Patients With T1 or T2 Clinically N0 Oral Cavity Squamous Cell Carcinoma
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 161
- 主要终点
- Proportion of non-SLN(s) negative patients
研究概览
简要总结
RATIONALE: Diagnostic procedures to detect cancer cells in sentinel lymph nodes may help plan effective cancer treatment.
PURPOSE: Diagnostic trial to study the effectiveness of lymph node mapping and sentinel lymph node lymphadenectomy in patients who are undergoing surgery to remove early-stage cancer of the mouth.
详细描述
OBJECTIVES:
- Determine whether a negative hematoxylin and eosin finding from the lymphatic mapping and sentinel node lymphadenectomy procedure accurately predicts the negativity of the other cervical lymph nodes in patients with stage I or II squamous cell carcinoma of the oral cavity.
- Determine the extent and pattern of disease spread in the nodal bed in these patients.
- Obtain data on the use of immunohistochemistry to assess nodes in these patients.
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Diagnostic
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient must be > 18 years of age.
- •Patient must have an ECOG/Zubrod performance status of <
- •Patient must have a histologically confirmed primary T1 or T2 invasive OCSCCA that is > 6mm and < 4 cm in size. The primary tumor must be amenable to curative resection and must be diagnosed within 42 days prior to surgery.
- •Patient must be clinically stage N0 confirmed with a negative imaging study employing contrastenhanced CT scan (or MRI with gadolinium in patients with iodine allergy). Lymph nodes will be considered positive if:
- •Greater than 1.5 cm in size for levels I and II.
- •Greater than 1 cm in size for levels III, IV, V and VI.
- •If any lymph node exhibits central necrosis, irregular enhancement of a poorly defined or irregular capsular border.
- •Groups of three or more asymmetrically located LNs, with a minimal axial diameter of 8 mm or more, in the suspected tumor drainage area are present.
- •NOTE: All CT scans must be read by a neuroradiologist.
- •Patient must be medically fit for neck dissection.
- •Patient or the patient's legally acceptable representative must provide a signed and dated written informed consent prior to registration or any study-related procedures.
- •Female patient of childbearing potential must have negative serum pregnancy test within 30 daysprior to registration.
- •If the patient is a survivor of a prior cancer, ALL of the following criteria are met:
- •Patient has undergone potentially curative therapy for all prior malignancies,
- •No evidence of any prior malignancies for at least 5 years with no evidence of recurrence (except for effectively treated basal cell or squamous carcinoma of the skin, carcinoma in-situ of the cervix that has been effectively treated by surgery alone, or lobular carcinoma in-situ of the ipsilateral or contralateral breast treated by surgery alone),
- •Patient is deemed by their treating physician to be at low risk for recurrence from prior malignancies.
排除标准
- •Patient received prior treatment to the cervical lymph nodes, including surgery or radiation therapy.
- •Patient experienced prior extensive trauma to the anterior cervical region of the neck.
- •Patient has lesions that cross the vermilion border involving lip skin.
- •Patient has had previous tumor resection involving the neck.
- •Patient has had injections of radioactive material for previous scans within 48 hours of the radiolymphoscintigraphy.
研究组 & 干预措施
Radiolymphoscintigraphy + surgery
Patients undergo radiolymphoscintigraphy comprising technetium Tc 99m sulfur colloid to identify the sentinel lymph nodes (SNL). Within 18 hours after radiolymphoscintigraphy, patients undergo resection of the primary oral cavity tumor and radioguided sentinel lymphadenectomy and regional cervical lymphadenectomy. Lymph nodes are examined by hematoxylin and eosin (H&E) staining. If negative by H&E, lymph nodes are further analyzed by immunohistochemistry.
Patients are followed at 30 days.
干预措施: conventional surgery (Procedure)
Radiolymphoscintigraphy + surgery
Patients undergo radiolymphoscintigraphy comprising technetium Tc 99m sulfur colloid to identify the sentinel lymph nodes (SNL). Within 18 hours after radiolymphoscintigraphy, patients undergo resection of the primary oral cavity tumor and radioguided sentinel lymphadenectomy and regional cervical lymphadenectomy. Lymph nodes are examined by hematoxylin and eosin (H&E) staining. If negative by H&E, lymph nodes are further analyzed by immunohistochemistry.
Patients are followed at 30 days.
干预措施: lymphangiography (Procedure)
Radiolymphoscintigraphy + surgery
Patients undergo radiolymphoscintigraphy comprising technetium Tc 99m sulfur colloid to identify the sentinel lymph nodes (SNL). Within 18 hours after radiolymphoscintigraphy, patients undergo resection of the primary oral cavity tumor and radioguided sentinel lymphadenectomy and regional cervical lymphadenectomy. Lymph nodes are examined by hematoxylin and eosin (H&E) staining. If negative by H&E, lymph nodes are further analyzed by immunohistochemistry.
Patients are followed at 30 days.
干预措施: radionuclide imaging (Procedure)
Radiolymphoscintigraphy + surgery
Patients undergo radiolymphoscintigraphy comprising technetium Tc 99m sulfur colloid to identify the sentinel lymph nodes (SNL). Within 18 hours after radiolymphoscintigraphy, patients undergo resection of the primary oral cavity tumor and radioguided sentinel lymphadenectomy and regional cervical lymphadenectomy. Lymph nodes are examined by hematoxylin and eosin (H&E) staining. If negative by H&E, lymph nodes are further analyzed by immunohistochemistry.
Patients are followed at 30 days.
干预措施: sentinel lymph node biopsy (Procedure)
Radiolymphoscintigraphy + surgery
Patients undergo radiolymphoscintigraphy comprising technetium Tc 99m sulfur colloid to identify the sentinel lymph nodes (SNL). Within 18 hours after radiolymphoscintigraphy, patients undergo resection of the primary oral cavity tumor and radioguided sentinel lymphadenectomy and regional cervical lymphadenectomy. Lymph nodes are examined by hematoxylin and eosin (H&E) staining. If negative by H&E, lymph nodes are further analyzed by immunohistochemistry.
Patients are followed at 30 days.
干预措施: technetium Tc 99m sulfur colloid (Radiation)
Radiolymphoscintigraphy + surgery
Patients undergo radiolymphoscintigraphy comprising technetium Tc 99m sulfur colloid to identify the sentinel lymph nodes (SNL). Within 18 hours after radiolymphoscintigraphy, patients undergo resection of the primary oral cavity tumor and radioguided sentinel lymphadenectomy and regional cervical lymphadenectomy. Lymph nodes are examined by hematoxylin and eosin (H&E) staining. If negative by H&E, lymph nodes are further analyzed by immunohistochemistry.
Patients are followed at 30 days.
干预措施: immunohistochemistry staining method (Other)
结局指标
主要结局
Proportion of non-SLN(s) negative patients
时间窗: Up to 30 days
次要结局
未报告次要终点
