- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04333537
Comparing Sentinel Lymph Node (SLN) Biopsy With Standard Neck Dissection for Patients With Early-Stage Oral Cavity Cancer
Randomized Phase II/III Trial of Sentinel Lymph Node Biopsy Versus Elective Neck Dissection for Early-Stage Oral Cavity Cancer
Study Overview
Status
Conditions
- Oral Cavity Squamous Cell Carcinoma
- Stage I Lip and Oral Cavity Cancer AJCC v8
- Stage II Lip and Oral Cavity Cancer AJCC v8
- Buccal Mucosa Squamous Cell Carcinoma
- Floor of Mouth Squamous Cell Carcinoma
- Gingival Squamous Cell Carcinoma
- Hard Palate Squamous Cell Carcinoma
- Lip Squamous Cell Carcinoma
- Lower Alveolar Ridge Squamous Cell Carcinoma
- Retromolar Trigone Squamous Cell Carcinoma
- Tongue Squamous Cell Carcinoma
- Upper Alveolar Ridge Squamous Cell Carcinoma
Detailed Description
PRIMARY OBJECTIVES:
I. To determine if patient-reported neck and shoulder function and related quality of life (QOL) at 6 months after surgery using the Neck Dissection Impairment Index (NDII) is superior with sentinel lymph node (SLN) biopsy compared to elective neck dissection (END) for treatment of early-stage oral cavity squamous cell carcinoma (OCSCC) (cT1-2N0). (Phase II) II. To determine if disease-free survival (DFS) is non-inferior with SLN biopsy compared to END for treatment of early-stage OCSCC (cT1-2N0). (Phase III) III. To determine if patient-reported neck and shoulder function and related QOL at 6 months after surgery using NDII is superior with SLN biopsy compared to END for treatment of early-stage OCSCC (cT1-2N0). (Phase III)
SECONDARY OBJECTIVES:
I. To compare patterns of failure (local-regional relapse and distant metastasis) between surgical arms.
II. To measure and compare overall survival (OS) between surgical arms. III. To measure and compare the toxicity of the two surgical arms.
IV. To measure longitudinal patient-reported neck and shoulder function and related QOL between surgical arms, using the following instruments:
IVa. Neck Dissection Impairment Index (NDII). IVb. Abbreviated Disabilities of the Arm, Shoulder and Hand (QuickDASH). IVc. Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N). V. To assess the length of hospitalization, post-operative drain placement, and operative morbidity between arms.
VI. To estimate the negative predictive rate of fludeoxyglucose F-18 (FDG)-positron emission tomography/computed tomography (PET/CT) for N0 neck in patients with T1 and T1-2 oral cavity squamous cell cancer (OCSCC) patients in the END arm.
VII. To assess nodal metastases rates between arms. VIII. To assess the pathologic false omission rate (FOR) in the SLN biopsy arm. IX. To determine if patient-reported neck and shoulder function and related QOL at 6 months after surgery using the NDII is superior with the SLN biopsy compared to the END in low-risk patients.
EXPLORATORY OBJECTIVES:
I. To compare changes in patient-reported outcomes (European Quality of Life Five Dimension Five Level Scale Questionnaire [EQ-5D-5L]) between surgical arms.
II. To collect biospecimens for future translational science studies. III. To assess the DFS between arms in low-risk patients.
OUTLINE: Patients are randomized to 1 of 2 groups.
GROUP I: Patients receive an imaging agent via injection and undergo planar imaging and single photo emission computed tomography/computed tomography (SPECT/CT) over 1-2 hours. Patients then undergo SLN biopsy.
GROUP II: Patients undergo standard END.
After completion of study treatment, patients are followed up 3 weeks after surgery, every 3 months for year 1, every 4 months for year 2, every 6 months for year 3, then yearly thereafter.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
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Ontario
-
Toronto, Ontario, Canada, M5G 2M9
- Recruiting
- University Health Network-Princess Margaret Hospital
-
Principal Investigator:
- John R. de Almeida
-
Contact:
- Site Public Contact
- Phone Number: 416-946-4501
- Email: clinical.trials@uhn.on.ca
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-
-
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Arizona
-
Tucson, Arizona, United States, 85719
- Recruiting
- Banner University Medical Center - Tucson
-
Principal Investigator:
- Steven J. Wang
-
Contact:
- Site Public Contact
- Email: UACC-IIT@uacc.arizona.edu
-
Tucson, Arizona, United States, 85719
- Recruiting
- University of Arizona Cancer Center-North Campus
-
Principal Investigator:
- Steven J. Wang
-
Contact:
- Site Public Contact
- Email: UACC-IIT@uacc.arizona.edu
-
-
Arkansas
-
Little Rock, Arkansas, United States, 72205
- Recruiting
- University of Arkansas for Medical Sciences
-
Principal Investigator:
- Emre A. Vural
-
Contact:
- Site Public Contact
- Phone Number: 501-686-8274
-
-
California
-
Duarte, California, United States, 91010
- Recruiting
- City of Hope Comprehensive Cancer Center
-
Principal Investigator:
- Ellie G. Maghami
-
Contact:
- Site Public Contact
- Phone Number: 800-826-4673
- Email: becomingapatient@coh.org
-
La Jolla, California, United States, 92093
- Recruiting
- UC San Diego Moores Cancer Center
-
Principal Investigator:
- Theresa Guo
-
Contact:
- Site Public Contact
- Phone Number: 858-822-5354
- Email: cancercto@ucsd.edu
-
Palo Alto, California, United States, 94304
- Recruiting
- Stanford Cancer Institute Palo Alto
-
Principal Investigator:
- Fred Baik
-
Contact:
- Site Public Contact
- Phone Number: 650-498-7061
- Email: ccto-office@stanford.edu
-
Sacramento, California, United States, 95817
- Active, not recruiting
- University of California Davis Comprehensive Cancer Center
-
San Jose, California, United States, 95124
- Recruiting
- Stanford Cancer Center South Bay
-
Principal Investigator:
- Fred Baik
-
Contact:
- Site Public Contact
- Phone Number: 650-498-7061
- Email: ccto-office@stanford.edu
-
-
Connecticut
-
New Haven, Connecticut, United States, 06520
- Recruiting
- Yale University
-
Principal Investigator:
- Saral Mehra
-
Contact:
- Site Public Contact
- Phone Number: 203-785-5702
- Email: canceranswers@yale.edu
-
Trumbull, Connecticut, United States, 06611
- Recruiting
- Smilow Cancer Hospital Care Center-Trumbull
-
Principal Investigator:
- Saral Mehra
-
Contact:
- Site Public Contact
- Phone Number: 203-785-5702
- Email: canceranswers@yale.edu
-
-
Florida
-
Coral Gables, Florida, United States, 33146
- Recruiting
- UM Sylvester Comprehensive Cancer Center at Coral Gables
-
Principal Investigator:
- Francisco J. Civantos
-
Contact:
- Site Public Contact
- Phone Number: 305-243-2647
-
Deerfield Beach, Florida, United States, 33442
- Recruiting
- UM Sylvester Comprehensive Cancer Center at Deerfield Beach
-
Principal Investigator:
- Francisco J. Civantos
-
Contact:
- Site Public Contact
- Phone Number: 305-243-2647
-
Miami, Florida, United States, 33136
- Recruiting
- University of Miami Miller School of Medicine-Sylvester Cancer Center
-
Principal Investigator:
- Francisco J. Civantos
-
Contact:
- Site Public Contact
- Phone Number: 305-243-2647
-
-
Georgia
-
Atlanta, Georgia, United States, 30322
- Recruiting
- Emory University Hospital/Winship Cancer Institute
-
Principal Investigator:
- Jennifer Gross
-
Contact:
- Site Public Contact
- Phone Number: 404-778-1868
-
Atlanta, Georgia, United States, 30308
- Recruiting
- Emory University Hospital Midtown
-
Principal Investigator:
- Jennifer Gross
-
Contact:
- Site Public Contact
- Phone Number: 888-946-7447
-
-
Illinois
-
Chicago, Illinois, United States, 60612
- Recruiting
- Rush University Medical Center
-
Principal Investigator:
- Mihir K. Bhayani
-
Contact:
- Site Public Contact
- Phone Number: 312-942-5498
- Email: clinical_trials@rush.edu
-
Chicago, Illinois, United States, 60611
- Recruiting
- Northwestern University
-
Principal Investigator:
- Sandeep Samant
-
Contact:
- Site Public Contact
- Phone Number: 312-695-1301
- Email: cancer@northwestern.edu
-
Springfield, Illinois, United States, 62781
- Suspended
- Memorial Medical Center
-
Springfield, Illinois, United States, 62702
- Suspended
- Southern Illinois University School of Medicine
-
-
Iowa
-
Iowa City, Iowa, United States, 52242
- Recruiting
- University of Iowa/Holden Comprehensive Cancer Center
-
Principal Investigator:
- Nitin A. Pagedar
-
Contact:
- Site Public Contact
- Phone Number: 800-237-1225
-
-
Kansas
-
Kansas City, Kansas, United States, 66160
- Recruiting
- University of Kansas Cancer Center
-
Principal Investigator:
- Andres M. Bur
-
Contact:
- Site Public Contact
- Phone Number: 913-588-3671
- Email: KUCC_Navigation@kumc.edu
-
Westwood, Kansas, United States, 66205
- Recruiting
- University of Kansas Hospital-Westwood Cancer Center
-
Principal Investigator:
- Andres M. Bur
-
Contact:
- Site Public Contact
- Phone Number: 913-588-3671
- Email: KUCC_Navigation@kumc.edu
-
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Kentucky
-
Lexington, Kentucky, United States, 40536
- Active, not recruiting
- University of Kentucky/Markey Cancer Center
-
Louisville, Kentucky, United States, 40202
- Suspended
- The James Graham Brown Cancer Center at University of Louisville
-
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Louisiana
-
Shreveport, Louisiana, United States, 71103
- Recruiting
- LSU Health Sciences Center at Shreveport
-
Principal Investigator:
- John Pang
-
Contact:
- Site Public Contact
- Phone Number: 318-813-1404
- Email: LPost@lsuhsc.edu
-
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Massachusetts
-
Boston, Massachusetts, United States, 02118
- Suspended
- Boston Medical Center
-
-
Michigan
-
Ann Arbor, Michigan, United States, 48109
- Recruiting
- University of Michigan Comprehensive Cancer Center
-
Principal Investigator:
- Steven B. Chinn
-
Contact:
- Site Public Contact
- Phone Number: 800-865-1125
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Detroit, Michigan, United States, 48201
- Recruiting
- Wayne State University/Karmanos Cancer Institute
-
Principal Investigator:
- John D. Cramer
-
Contact:
- Site Public Contact
- Phone Number: 313-576-9790
- Email: ctoadmin@karmanos.org
-
Detroit, Michigan, United States, 48202
- Recruiting
- Henry Ford Hospital
-
Contact:
- Site Public Contact
- Phone Number: 313-916-3721
- Email: CTOResearch@hfhs.org
-
Principal Investigator:
- Eleanor M. Walker
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Farmington Hills, Michigan, United States, 48334
- Recruiting
- Weisberg Cancer Treatment Center
-
Principal Investigator:
- John D. Cramer
-
Contact:
- Site Public Contact
- Phone Number: 313-576-9790
- Email: ctoadmin@karmanos.org
-
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Nebraska
-
Omaha, Nebraska, United States, 68114
- Recruiting
- Nebraska Cancer Specialists/Oncology Hematology West PC - MECC
-
Principal Investigator:
- Aru Panwar
-
Contact:
- Site Public Contact
- Phone Number: 402-334-4773
-
Omaha, Nebraska, United States, 68114
- Recruiting
- Nebraska Methodist Hospital
-
Principal Investigator:
- Aru Panwar
-
Contact:
- Site Public Contact
- Phone Number: 402-354-5144
-
Omaha, Nebraska, United States, 68114
- Recruiting
- Oncology Associates PC
-
Principal Investigator:
- Aru Panwar
-
Contact:
- Site Public Contact
- Phone Number: 402-354-5860
- Email: info@oa-oc.com
-
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New Jersey
-
Basking Ridge, New Jersey, United States, 07920
- Recruiting
- Memorial Sloan Kettering Basking Ridge
-
Principal Investigator:
- Jennifer R. Cracchiolo
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
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Livingston, New Jersey, United States, 07039
- Recruiting
- Saint Barnabas Medical Center
-
Principal Investigator:
- Dylan F. Roden
-
Contact:
- Site Public Contact
- Phone Number: 973-322-2934
- Email: joanne.loeb@rwjbh.org
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Middletown, New Jersey, United States, 07748
- Recruiting
- Memorial Sloan Kettering Monmouth
-
Principal Investigator:
- Jennifer R. Cracchiolo
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Montvale, New Jersey, United States, 07645
- Recruiting
- Memorial Sloan Kettering Bergen
-
Principal Investigator:
- Jennifer R. Cracchiolo
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
New Brunswick, New Jersey, United States, 08903
- Recruiting
- Rutgers Cancer Institute of New Jersey
-
Principal Investigator:
- Dylan F. Roden
-
Contact:
- Site Public Contact
- Phone Number: 732-235-7356
-
-
New York
-
Buffalo, New York, United States, 14263
- Recruiting
- Roswell Park Cancer Institute
-
Principal Investigator:
- Ryan P. McSpadden
-
Contact:
- Site Public Contact
- Phone Number: 800-767-9355
- Email: askroswell@roswellpark.org
-
Commack, New York, United States, 11725
- Recruiting
- Memorial Sloan Kettering Commack
-
Principal Investigator:
- Jennifer R. Cracchiolo
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Harrison, New York, United States, 10604
- Recruiting
- Memorial Sloan Kettering Westchester
-
Principal Investigator:
- Jennifer R. Cracchiolo
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
Lake Success, New York, United States, 11042
- Active, not recruiting
- Northwell Health/Center for Advanced Medicine
-
Mineola, New York, United States, 11501
- Recruiting
- NYU Winthrop Hospital
-
Principal Investigator:
- Umamaheswar Duvvuri
-
Contact:
- Site Public Contact
- Phone Number: 212-263-4432
- Email: cancertrials@nyulangone.org
-
New Hyde Park, New York, United States, 11040
- Active, not recruiting
- Long Island Jewish Medical Center
-
New York, New York, United States, 10065
- Recruiting
- Memorial Sloan Kettering Cancer Center
-
Principal Investigator:
- Jennifer R. Cracchiolo
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
New York, New York, United States, 10016
- Recruiting
- Laura and Isaac Perlmutter Cancer Center at NYU Langone
-
Principal Investigator:
- Umamaheswar Duvvuri
-
Contact:
- Site Public Contact
- Email: CancerTrials@nyulangone.org
-
New York, New York, United States, 10021
- Active, not recruiting
- Lenox Hill Hospital
-
New York, New York, United States, 10065
- Active, not recruiting
- Manhattan Eye Ear and Throat Hospital
-
Uniondale, New York, United States, 11553
- Recruiting
- Memorial Sloan Kettering Nassau
-
Principal Investigator:
- Jennifer R. Cracchiolo
-
Contact:
- Site Public Contact
- Phone Number: 212-639-7592
-
-
North Dakota
-
Fargo, North Dakota, United States, 58122
- Suspended
- Sanford Roger Maris Cancer Center
-
Fargo, North Dakota, United States, 58122
- Suspended
- Sanford Broadway Medical Center
-
-
Ohio
-
Cleveland, Ohio, United States, 44195
- Recruiting
- Cleveland Clinic Foundation
-
Principal Investigator:
- Jamie A. Ku
-
Contact:
- Site Public Contact
- Phone Number: 866-223-8100
- Email: TaussigResearch@ccf.org
-
Columbus, Ohio, United States, 43210
- Recruiting
- Ohio State University Comprehensive Cancer Center
-
Principal Investigator:
- Amit Agrawal
-
Contact:
- Site Public Contact
- Phone Number: 800-293-5066
- Email: Jamesline@osumc.edu
-
-
Oklahoma
-
Oklahoma City, Oklahoma, United States, 73104
- Recruiting
- University of Oklahoma Health Sciences Center
-
Principal Investigator:
- Rusha J. Patel
-
Contact:
- Site Public Contact
- Phone Number: 405-271-8777
- Email: ou-clinical-trials@ouhsc.edu
-
-
Oregon
-
Clackamas, Oregon, United States, 97015
- Recruiting
- Clackamas Radiation Oncology Center
-
Contact:
- Site Public Contact
- Phone Number: 503-215-2614
- Email: CanRsrchStudies@providence.org
-
Principal Investigator:
- Nitya Alluri
-
Newberg, Oregon, United States, 97132
- Suspended
- Providence Newberg Medical Center
-
Portland, Oregon, United States, 97213
- Recruiting
- Providence Portland Medical Center
-
Contact:
- Site Public Contact
- Phone Number: 503-215-2614
- Email: CanRsrchStudies@providence.org
-
Principal Investigator:
- Nitya Alluri
-
Portland, Oregon, United States, 97225
- Recruiting
- Providence Saint Vincent Medical Center
-
Contact:
- Site Public Contact
- Phone Number: 503-215-2614
- Email: CanRsrchStudies@providence.org
-
Principal Investigator:
- Nitya Alluri
-
-
Pennsylvania
-
Danville, Pennsylvania, United States, 17822
- Recruiting
- Geisinger Medical Center
-
Principal Investigator:
- Nicholas Purdy
-
Contact:
- Site Public Contact
- Phone Number: 570-271-5251
- Email: HemonCCTrials@geisinger.edu
-
Hershey, Pennsylvania, United States, 17033-0850
- Suspended
- Penn State Milton S Hershey Medical Center
-
Philadelphia, Pennsylvania, United States, 19107
- Recruiting
- Thomas Jefferson University Hospital
-
Principal Investigator:
- David M. Cognetti
-
Contact:
- Site Public Contact
- Phone Number: 215-600-9151
- Email: ONCTrialNow@jefferson.edu
-
Philadelphia, Pennsylvania, United States, 19111
- Active, not recruiting
- Fox Chase Cancer Center
-
Pittsburgh, Pennsylvania, United States, 15232
- Recruiting
- University of Pittsburgh Cancer Institute (UPCI)
-
Principal Investigator:
- Mark Kubik
-
Contact:
- Site Public Contact
- Phone Number: 412-647-8073
-
Pittsburgh, Pennsylvania, United States, 15232
- Recruiting
- UPMC-Shadyside Hospital
-
Principal Investigator:
- Mark Kubik
-
Contact:
- Site Public Contact
- Phone Number: 412-621-2334
-
-
South Dakota
-
Sioux Falls, South Dakota, United States, 57104
- Recruiting
- Sanford Cancer Center Oncology Clinic
-
Principal Investigator:
- Daniel Almquist
-
Contact:
- Site Public Contact
- Phone Number: 605-312-3320
- Email: OncologyClinicTrialsSF@sanfordhealth.org
-
Sioux Falls, South Dakota, United States, 57117-5134
- Recruiting
- Sanford USD Medical Center - Sioux Falls
-
Principal Investigator:
- Daniel Almquist
-
Contact:
- Site Public Contact
- Phone Number: 605-312-3320
- Email: OncologyClinicalTrialsSF@SanfordHealth.org
-
Sioux Falls, South Dakota, United States, 57105
- Recruiting
- Avera Cancer Institute
-
Contact:
- Site Public Contact
- Phone Number: 605-322-3095
- Email: OncRegulatory@avera.org
-
Principal Investigator:
- William C. Spanos
-
-
Tennessee
-
Memphis, Tennessee, United States, 38163
- Recruiting
- University of Tennessee Health Science Center
-
Contact:
- Site Public Contact
- Phone Number: 901-683-0055
- Email: afletcher@westclinic.com
-
Principal Investigator:
- John P. Gleysteen
-
Memphis, Tennessee, United States, 38104
- Recruiting
- Methodist Hospital
-
Contact:
- Site Public Contact
- Phone Number: 901-516-2579
-
Principal Investigator:
- John P. Gleysteen
-
Nashville, Tennessee, United States, 37232
- Recruiting
- Vanderbilt University/Ingram Cancer Center
-
Principal Investigator:
- Michael C. Topf
-
Contact:
- Site Public Contact
- Phone Number: 800-811-8480
-
-
Texas
-
Conroe, Texas, United States, 77384
- Recruiting
- MD Anderson in The Woodlands
-
Principal Investigator:
- Ann M. Gillenwater
-
Contact:
- Site Public Contact
- Phone Number: 866-632-6789
- Email: askmdanderson@mdanderson.org
-
Houston, Texas, United States, 77030
- Recruiting
- M D Anderson Cancer Center
-
Principal Investigator:
- Ann M. Gillenwater
-
Contact:
- Site Public Contact
- Phone Number: 877-632-6789
- Email: askmdanderson@mdanderson.org
-
Houston, Texas, United States, 77030
- Recruiting
- Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
-
Principal Investigator:
- Vlad C. Sandulache
-
Contact:
- Site Public Contact
- Phone Number: 713-798-1354
- Email: burton@bcm.edu
-
Houston, Texas, United States, 77079
- Recruiting
- MD Anderson West Houston
-
Principal Investigator:
- Ann M. Gillenwater
-
Contact:
- Site Public Contact
- Phone Number: 877-632-6789
- Email: askmdanderson@mdanderson.org
-
Houston, Texas, United States, 77030
- Recruiting
- Michael E DeBakey VA Medical Center
-
Principal Investigator:
- Vlad C. Sandulache
-
Contact:
- Site Public Contact
- Phone Number: 800-553-2278
-
League City, Texas, United States, 77573
- Recruiting
- MD Anderson League City
-
Principal Investigator:
- Ann M. Gillenwater
-
Contact:
- Site Public Contact
- Phone Number: 877-632-6789
- Email: askmdanderson@mdanderson.org
-
Sugar Land, Texas, United States, 77478
- Recruiting
- MD Anderson in Sugar Land
-
Principal Investigator:
- Ann M. Gillenwater
-
Contact:
- Site Public Contact
- Phone Number: 877-632-6789
- Email: askmdanderson@mdanderson.org
-
-
Vermont
-
Berlin, Vermont, United States, 05602
- Recruiting
- Central Vermont Medical Center/National Life Cancer Treatment
-
Principal Investigator:
- Mirabelle Sajisevi
-
Contact:
- Site Public Contact
- Phone Number: 802-225-5400
-
Burlington, Vermont, United States, 05401
- Recruiting
- University of Vermont Medical Center
-
Principal Investigator:
- Mirabelle Sajisevi
-
Contact:
- Site Public Contact
- Phone Number: 802-656-4101
- Email: rpo@uvm.edu
-
Burlington, Vermont, United States, 05405
- Recruiting
- University of Vermont and State Agricultural College
-
Principal Investigator:
- Mirabelle Sajisevi
-
Contact:
- Site Public Contact
- Phone Number: 802-656-8990
- Email: rpo@uvm.edu
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- PRIOR TO STEP 1 REGISTRATION INCLUSION:
- Pathologically (histologically or cytologically) proven diagnosis of squamous cell carcinoma of the oral cavity, including the oral (mobile) tongue, floor of mouth (FOM), mucosal lip, buccal mucosa, lower alveolar ridge, upper alveolar ridge, retromolar gingiva (retromolar trigone; RMT), or hard palate prior to registration
Appropriate stage for study entry (T1-2N0M0; American Joint Committee on Cancer [AJCC] 8th edition [ed.]) based on the following diagnostic workup:
- History/physical examination within 42 days prior to registration
Imaging of head and neck within 42 days prior to registration
- PET/CT scan or contrast neck CT scan, or gadolinium-enhanced neck magnetic resonance imaging (MRI) or lateral and central neck ultrasound; diagnostic quality CT is preferred and highly recommended for the PET/CT when possible.
- Imaging of chest within 42 days prior to registration; chest x-ray, CT chest scan (with or without contrast) or PET/CT (with or without contrast)
Surgical assessment within 42 days prior to registration. Patient must be a candidate for surgical intervention with sentinel lymph node (SLN) biopsy and potential completion neck dissection (CND) or elective neck dissection (END)
- Surgical resection of the primary tumor will occur through a transoral approach with anticipation of resection free margins
- Zubrod performance status 0-2 within 42 days prior to registration
- For women of child-bearing potential, negative serum or urine pregnancy test within 42 days prior to registration
- The patient or a legally authorized representative must provide study-specific informed consent prior to study entry
- Only patients who are able to read and understand English are eligible to participate as the mandatory patient reported NDII tool is only available in this language
- PRIOR TO STEP 2 RANDOMIZATION:
FDG PET/CT required prior to step 2. Note: FDG PET/CT done prior to step 1 can be submitted for central review.
- PET/CT node negative patients, determined by central read, will proceed to randomization.
PET/CT node positive patients will go off study, but will be entered in a registry and data will be collected to record the pathological outcome of neck nodes for diagnostic imaging assessment and future clinical trial development
- NOTE: All FDG PET/CT scans must be performed on an American College of Radiology (ACR) accredited scanner (or similar accrediting organization)
- The patient must complete NDII prior to step 2 registration
Exclusion Criteria:
- PRIOR TO STEP 1 REGISTRATION EXCLUSION:
- Definitive clinical or radiologic evidence of regional (cervical) and/or distant metastatic disease
- Prior non-head and neck invasive malignancy (except non-melanomatous skin cancer, including effectively treated basal cell or squamous cell skin cancer, or carcinoma in situ of the breast or cervix) unless disease free for ≥ 2 years
- Diagnosis of head and neck squamous cell carcinoma (SCC) in the oropharynx, nasopharynx, hypopharynx, and larynx
- Unable or unwilling to complete NDII (baseline only)
- Prior systemic chemotherapy for the study cancer; note that prior chemotherapy for a different cancer is allowable
- Prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields
- Patient with severe, active co-morbidity that would preclude an elective or completion neck dissection
- Pregnancy and breast-feeding mothers
- Incomplete resection of oral cavity lesion with a positive margin; however, an excisional biopsy is permitted
- Prior surgery involving the lateral neck, including neck dissection or gross injury to the neck that would preclude surgical dissection for this trial. Prior thyroid and central neck surgery is permissible; biopsy is permitted. Note: Borderline suspicious nodes that are ≥ 1 cm with radiographic finding suggestive of NOT malignant should be biopsied using ultrasound-guided (U/S-guided) fine-needle aspiration (FNA) biopsy
- Underlying or documented history of hematologic malignancy (e.g., chronic lymphocytic leukemia [CLL]) or other active disease capable of causing lymphadenopathy (sarcoidosis or untreated mycobacterial infection)
- Actively receiving systemic cytotoxic chemotherapy, immunosuppressive, anti-monocyte or immunomodulatory therapy
- Currently participating in another investigational therapeutic trial
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Sentinel Lymph Node (SLN) Biopsy
Patients receive an imaging agent via injection and undergo planar imaging and SPECT/CT over 1-2 hours.
Patients then undergo SLN biopsy.
|
Undergo SLN biopsy
Other Names:
Undergo planar imaging
Undergo SPECT/CT scan
Other Names:
Receive imaging agent via injection
Other Names:
Undergo SPECT/CT scan
Other Names:
|
Active Comparator: Elective Neck Dissection (END)
Patients undergo standard END.
|
Undergo SPECT/CT scan
Other Names:
Undergo standard elective neck dissection
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient-reported neck and shoulder function (Phase II/III)
Time Frame: From Baseline (Before surgery) to 6 months post-surgery
|
Will be evaluated and compared using the Neck Dissection Impairment Index (NDII), a 10-item tool between the two treatment arms.
It is assumed that a 7.5-point (change from Baseline to 6 months) between arm difference is clinically meaningful.
The hypothesis of no between-arm difference in 6-month NDII scores will be tested using the ANCOVA model at one-sided significance level of 0.10.
Point estimates and 95% confidence intervals (CIs) for the mean NDII scores at 6 months for each treatment arm and for the between-arm difference at 6-months based on the proposed model will be provided.
|
From Baseline (Before surgery) to 6 months post-surgery
|
Disease-Free Survival
Time Frame: From randomization to local/regional recurrence, distant metastasis, or death due to any cause, whichever comes first, assessed up to 11 years
|
An event for disease-free survival is local recurrence, regional recurrence, distant metastasis, or death due to any cause.
Disease-free survival time is randomization date to the date of event or last known follow-up (censoring).
Rates will be estimated using the Kaplan-Meier method and between-arm differences compared using the log-rank test.
|
From randomization to local/regional recurrence, distant metastasis, or death due to any cause, whichever comes first, assessed up to 11 years
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Overall Survival
Time Frame: From randomization to death due to any cause, assessed up to 11 years
|
An event for overall survival is death due to any cause.
Overall survival time is randomization date to date of event or last known follow-up (censoring).
Rates will be estimated using the Kaplan-Meier method and between-arm differences compared using the log-rank test.
|
From randomization to death due to any cause, assessed up to 11 years
|
Loco-regional Failure
Time Frame: From the time of randomization to the date of failure, date of precluding event, or last known follow-up date, assessed up to 11 years
|
An event for local-regional failure is local or regional recurrence.
Local-regional failure time is randomization date to date of event, precluding event, or last known follow-up (censoring).
Rates will be estimated using the cumulative incidence method and between arm differences compared using cause-specific log-rank test.
|
From the time of randomization to the date of failure, date of precluding event, or last known follow-up date, assessed up to 11 years
|
Distant metastasis
Time Frame: From the time of randomization to the date of distant metastasis, date of precluding event, or last known follow-up date, assessed up to 11 years
|
An event is the occurrence of distant metastasis.
Distant metastasis time is randomization to date of event, precluding event, or last known follow-up (censoring).
Rates will be estimated using the cumulative incidence method and between-arm differences compared using cause-specific log-rank test.
|
From the time of randomization to the date of distant metastasis, date of precluding event, or last known follow-up date, assessed up to 11 years
|
Patient-reported shoulder-related QOL, function impairment and disability
Time Frame: Baseline, 3 weeks, 3, 6, 12 months post-surgery. Analysis occurs at the same time as the primary endpoint.
|
Patient reported using Abbreviated Disabilities of the Arm, Shoulder, and Hand (QuickDASH) with scores of 0-100.
A higher score indicates greater disability.
|
Baseline, 3 weeks, 3, 6, 12 months post-surgery. Analysis occurs at the same time as the primary endpoint.
|
General quality of life
Time Frame: Baseline, 3 weeks, 3, 6, 12 months post-surgery. Analysis occurs at the same time as the primary endpoint.
|
Will be measured using the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) to measure Functional Assessment of Cancer Therapy-Head and Neck-Trial Outcome Index (FACT-TOI) scores on a scale from 0-96.
A higher score indicates better quality of life.
|
Baseline, 3 weeks, 3, 6, 12 months post-surgery. Analysis occurs at the same time as the primary endpoint.
|
Nodal metastasis detection rate
Time Frame: During surgery. Analysis occurs at the same time as the primary endpoint.
|
Defined as the proportion of patients with pathologic positive nodes using the pathology results.
|
During surgery. Analysis occurs at the same time as the primary endpoint.
|
Pathologic false omission rate
Time Frame: During surgery. Analysis occurs at the same time as the primary endpoint.
|
Measured within the sentinel lymph node biopsy (SLN) arm only.
Defined as the proportion of patients with false negative results among negative SLN patients.
|
During surgery. Analysis occurs at the same time as the primary endpoint.
|
Post-surgery patient-reported outcome
Time Frame: At 6 months post-surgery. Analysis occurs at the same time as the primary endpoint.
|
Measured by NDII in low-risk oral cavity squamous cell carcinoma patients using ANCOVA comparison model.
|
At 6 months post-surgery. Analysis occurs at the same time as the primary endpoint.
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Stephen Y Lai, NRG Oncology
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- NRG-HN006 (Other Identifier: CTEP)
- U10CA180868 (U.S. NIH Grant/Contract)
- NCI-2020-01542 (Registry Identifier: CTRP (Clinical Trial Reporting Program))
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
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