Randomized Comparison Between Sentinel Lymph Node Biopsy and Lymph Node Dissection in Early Stage Endometrial Cancer (SELYE)
Prospective Randomized Comparison of Sentinel Lymph Node Mapping Using Indocyanine Green and Conventional Pelvic Lymph Node Dissection in Clinical Stage I-II Endometrial Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The standard treatment for endometrial cancer is total hysterectomy and bilateral salpingo-oophorectomy, peritoneal cytology, and lymph node dissection. Pelvic lymph node dissection helps to set accurate staging and adjuvant therapy group, but it has never been proven to have therapeutic effects by itself. According to the results of two recent randomized clinical trials, routine pelvic lymph node dissection in early stage endometrial cancer doesn't improve survival rates.
Routine pelvic lymph node detection can cause complications in a large number of patients and is associated with poor quality of life. Therefore, it is important to develop a method that can check the status of the lymph node in a less invasive way. Efforts have been made to preserve other lymph nodes with significantly less potential for metastasis through less invasive methods, reducing lymph edema and complications such as bleeding and nerve damage caused by excessive surgery.
Sentinel lymph node dissection is used as a standard treatment for breast cancer and malignant melanoma, and efforts to develop it have recently continued in endometrial cancer and cervical cancer. A SENTICOL study conducted in cervical cancer patients showed a false-negative rate of 0% when both were monitored lymph node dissection. In addition, unlike routine pelvic lymph node dissection, ultra-staging through 0,2mm gas intercepts allow additional detection of less than 2mm of microtransfer or less than 0.2mm of independent tumor cells that have not been found before. In a recent large-scale prospective study of endometrial cancer, sentinel lymph node mapping using indocyanine green and fluorescent imaging was successful at 86%, and sensitivity (patient-by-patient analysis) reported 100% in diagnosis of lymph node metastasis.
As laparoscopic and robotic surgery account for most of the treatment of endometrial cancer patients, a good environment is created for monitoring lymph node exploration using ICG, and sensitivity and detection rate seem to have improved compared to the previous method. However, there has been no prospective study on the effects of patient clinical prognosis, such as a standard treatment, pelvic lymph node resection, and disease-free survival rate, and overall survival rate, so a prospective study is essential. The investigators compare survival rates in the group that does sentinel lymph node mapping and routine pelvic lymph node detection in endometrial cancer in clinical stage I-II.
Study Type
Study Type
Enrollment (Anticipated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Jeong-Yeol Park, M.D Ph.D.,
- Phone Number: +82-2-3010-3646
- Email: obgyjypark@amc.seoul.kr
Study Locations
-
-
-
Seoul, Korea, Republic of
- Recruiting
- Asan Medical Center
-
Contact:
- Jeong-Yeol Park
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 20 ~ 80 years old female
- histologically diagnosed endometrial cancer that has never been treated before.
- histological type :endometrioid, mucinous, serous, clear cell, uindifferentiated, dedifferentiated, mesonephric adenocarcinoma, mesonephric-like adenocarcinoma, carcinosarcoma, and mixed type
- histological grade : FIGO grade 1, 2, 3
- Presumed FIGO stage I-II
- Planed for laparoscopic or robotic hystererctomy and lymph adenectomy
- Largest pelvic or para-aortic lymph node diameter = or < 15 mm in short axis on MRI
- ECOG performance status 0-2
- ASA PS 0-2
- WBC ≥ 3,000/mm3, Platelets ≥ 100,000/mm3, Creatinine ≤ 2.0 mg/dL ,Bilirubin ≤ 1.5 x institutional upper limit normal ,SGOT, SGPT, and ALP ≤ 3 x institutional upper limit normal
- A patient who voluntarily signed a document for the study.
Exclusion Criteria:
- Presumed FIGO stage III-IV
- Neuroendocrine tumor histology
- Other disease involving lymphatic system
- lymphedema of the lower extremity or inguinal area
- previous pelvic or paraaortic lymph node dissection
- previous radiation or concurrent chemoradiation therapy of abdomen or pelvis
- previous chemotherapy due to malignant disease of abdomen or pelvis
- Patients who have had or have been treated for cancer within five years, other than non-melanoma skin cancer, carcinoma in situ of uterine cervix, stomach or bladder
- severe, uncontrolled underlying diseases or underlying disease with complications
- hypersensitivity to indocyanine green
- a pregnant or breast-feeding woman
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Sentinel lymph node mapping
The group composed of patients who undergo sentinel lymph node mapping
|
Laparoscopic or robotic hysterectomy with/without bilateral salpingo-oophorectomy 2. Inject 1.25 mg/ml of ICG and a total of 6ml into the cornual area (0.5-1 cm deep) of the uterus. And then inject 1 ml of mucous membrane (1-3 mm deep) and 1 ml of substrate (1-2 cm deep) into the cervix, and a total of 4 ml in each direction of 3 and 9 o'clock. 3. Sentinel lymph node is excised
Other Names:
|
|
Active Comparator: Routine lymph node dissection
The group composed of patients who undergo routine pelvic lymph node dissection
|
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The 3-year disease-free survival (3-year DFS)
Time Frame: 3 years
|
The time interval between the date of surgery and the date of recurrence will be caculated as month.
The survival curve will be calculated suing Kaplan-Meir method, and survival difference will be compared using Log-rank test.
|
3 years
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Surgery-related morbidity rate
Time Frame: One month
|
Compare the surgery-related morbidity rate after one month of surgery.
|
One month
|
|
Incidence of lymphocele and lymphedema
Time Frame: 3 years
|
After 3 years of surgery, the incidence of lymphocele and lymphedema are compared.
|
3 years
|
|
The 3-year overall survival (3-year OS)
Time Frame: 3 years
|
The time interval between the date of surgery and the date of death of disease will be caculated as month.
The survival curve will be calculated suing Kaplan-Meir method, and survival difference will be compared using Log-rank test.
|
3 years
|
|
The 5-year disease free survival (5-year DFS)
Time Frame: 5 years
|
The time interval between the date of surgery and the date of recurrence will be caculated as month.
The survival curve will be calculated suing Kaplan-Meir method, and survival difference will be compared using Log-rank test.
|
5 years
|
|
The 5-year overall survival (5-year OS)
Time Frame: 5-years
|
The time interval between the date of surgery and the date of death of disease will be caculated as month.
The survival curve will be calculated suing Kaplan-Meir method, and survival difference will be compared using Log-rank test.
|
5-years
|
|
The pattern of recurrence
Time Frame: 3 years
|
Anatomic location of first recurrence
|
3 years
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
General Publications
- Lecuru F, Mathevet P, Querleu D, Leblanc E, Morice P, Darai E, Marret H, Magaud L, Gillaizeau F, Chatellier G, Dargent D. Bilateral negative sentinel nodes accurately predict absence of lymph node metastasis in early cervical cancer: results of the SENTICOL study. J Clin Oncol. 2011 May 1;29(13):1686-91. doi: 10.1200/JCO.2010.32.0432. Epub 2011 Mar 28.
- Ballester M, Dubernard G, Lecuru F, Heitz D, Mathevet P, Marret H, Querleu D, Golfier F, Leblanc E, Rouzier R, Darai E. Detection rate and diagnostic accuracy of sentinel-node biopsy in early stage endometrial cancer: a prospective multicentre study (SENTI-ENDO). Lancet Oncol. 2011 May;12(5):469-76. doi: 10.1016/S1470-2045(11)70070-5. Epub 2011 Apr 12.
- Bae HS, Lim MC, Lee JS, Lee Y, Nam BH, Seo SS, Kang S, Chung SH, Kim JY, Park SY. Postoperative Lower Extremity Edema in Patients with Primary Endometrial Cancer. Ann Surg Oncol. 2016 Jan;23(1):186-95. doi: 10.1245/s10434-015-4613-1. Epub 2015 May 19.
- Tanner EJ, Sinno AK, Stone RL, Levinson KL, Long KC, Fader AN. Factors associated with successful bilateral sentinel lymph node mapping in endometrial cancer. Gynecol Oncol. 2015 Sep;138(3):542-7. doi: 10.1016/j.ygyno.2015.06.024. Epub 2015 Jun 19.
- Park JY, Kim JH, Baek MH, Park E, Kim SW. Randomized comparison between sentinel lymph node mapping using indocyanine green plus a fluorescent camera versus lymph node dissection in clinical stage I-II endometrial cancer: a Korean Gynecologic Oncology Group trial (KGOG2029/SELYE). J Gynecol Oncol. 2022 Nov;33(6):e73. doi: 10.3802/jgo.2022.33.e73. Epub 2022 Jul 25.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Anticipated)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- KGOG 2029
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Endometrial Cancer
-
NCT07514078Not yet recruitingTreatment Endometrial Cancer
-
NCT03621904RecruitingEndometrial Cancer Recurrent | Endometrial Cancer Stage III | Endometrial Cancer Stage IV
-
NCT03580421CompletedEndometrial Cancer Stage I | Endometrial Cancer Stage II
-
NCT07062016RecruitingEndometrial Carcinoma | Stage III Endometrial Cancer | Stage IV Endometrial Cancer | Endometrial High Grade Endometrioid Adenocarcinoma | Stage II Endometrial Cancer
-
NCT04917341CompletedGynecologic Cancer | Endometrial Cancer Stage
-
NCT01289041CompletedAdvanced Endometrial Cancer
-
NCT07634601Not yet recruitingRecurrent Endometrial Carcinoma | Advanced Endometrial Carcinoma | Metastatic Endometrial Carcinoma | Stage III Endometrial Cancer | Stage IV Endometrial Cancer
-
NCT00377520CompletedNeoplasms | Urogenital Neoplasms | Neoplasms by Site | Uterine Neoplasms | Genital Neoplasms, Female | Endometrial Neoplasms | Endometrial Cancer | Endometrium Cancer | Cancer of Endometrium | Cancer of the Endometrium
-
NCT01267357CompletedSerous Papillary Endometrial Cancer
-
NCT00542490CompletedEndometrial Cancer | Papillary Serous | Clear Cell Endometrial Cancer
Clinical Trials on Sentinel lymph node mapping
-
NCT00003325Completed
-
NCT04636710RecruitingBreast Cancer | Sentinel Lymph Node | Inflammatory Breast Cancer
-
NCT07391514Completed
-
NCT00386906CompletedMelanoma | Eye Disease
-
NCT05048173CompletedLymphadenectomy | Early Stage Endometrial Cancer | Sentinel Lymph Nodes
-
NCT05365191RecruitingBreast Cancer | Sentinel Lymph Node
-
NCT05365204Recruiting
-
NCT06619002RecruitingCervical Cancer | Artificial Intelligence | Endometrial Cancer | Deep Learning
-
NCT06900582Not yet recruitingEndometrial Cancer | Lymphadenectomy | Gene, p53 | Sentinel Lymph Node Biopsy (SLNB)
-
NCT07098507Not yet recruitingOmitting Sentinel Lymph Node Biopsy in Early-stage Breast Cancer