- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05830890
Sentinel Lymph Node Biopsy in Rectal Cancer
A Clinical Trial of Sentinel Lymph Node Biopsy in Rectal Cancer
Rectal cancer is one of the most common malignant tumors, with 9% to 23% of patients experiencing pelvic sidewall lymph node metastasis. According to the current Chinese guidelines for diagnosing and treating colorectal cancer, pelvic sidewall lymph node dissection is recommended for patients who have experienced or are suspected of having lateral lymph node metastasis. Lateral lymph node dissection can result in longer operation times, increased bleeding, and complications such as urinary and sexual dysfunction after surgery. Currently, the presence of metastasis is primarily determined by the size and enhancement characteristics of lateral lymph nodes observed through imaging studies. However, the pathological lymph node metastasis rate of specimens collected after lateral lymph node dissection based on current imaging criteria is only 20.5%. Therefore, a pressing clinical challenge is accurately determining the presence of lateral lymph node metastasis and avoiding unnecessary lateral lymph node dissection in patients who have not experienced lateral lymph node metastasis.
Sentinel lymph node biopsy has been widely used in clinical practice. It has replaced traditional lymph node dissection in some breast cancer and melanoma patients, reducing surgical risks and complications and improving patients' quality of life. This study aims to use indocyanine green as a tracer for fluorescence-guided laparoscopic navigation to locate the lateral sentinel lymph nodes of rectal cancer in the pelvic cavity. By studying the accuracy, specificity, and false-negative rate of predicting lateral lymph node status using the sentinel lymph node, we can further clarify the clinical significance of the lateral sentinel lymph node.
Study Overview
Status
Conditions
Detailed Description
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Yueyang Zhang, M.D.
- Phone Number: +8613552910035
- Email: yyzhang0129@163.com
Study Contact Backup
- Name: Zheng Xu, M.D.
- Phone Number: +8613141127297
- Email: 840677252@qq.com
Study Locations
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Beijing
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Beijing, Beijing, China, 100000
- National Cancer Center
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Contact:
- Yueyang Zhang, M.D.
- Phone Number: +8613552910035
- Email: yyzhang0129@163.com
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Contact:
- Haitao Zhou, M.D.
- Phone Number: +8613381167333
- Email: zhouhaitao01745@163.com
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Aged 18 to 75 years old.
- Eastern Cooperative Oncology Group (ECOG) performance status (PS) score of 0-1.
- Newly diagnosed patients with confirmed rectal cancer by histopathology.
- Preoperative clinical staging by imaging examination is T3-4.
- Preoperative colonoscopy shows the distance from the tumor's lower edge to the anus is less than 10cm.
- No previous chemotherapy or radiotherapy.
- Preoperative imaging examination (pelvic enhanced MRI) shows lateral lymph nodes with a maximum short diameter of ≥5mm and <10mm.
- Women of childbearing age must take effective contraceptive measures.
- Able to understand the study and sign the informed consent form.
Exclusion Criteria:
- Complete intestinal obstruction.
- Active hepatitis and peripheral neuropathy (such as peripheral neuritis, pseudomeningitis, motor neuritis, sensory disturbances, etc.).
- Pregnant or lactating women; women of childbearing potential who have not taken sufficient contraceptive measures.
- History of other tumors or previous chemotherapy or radiotherapy.
- Alcoholism or drug addiction.
- Significant organ dysfunction or other significant diseases, including clinically relevant coronary artery disease, cardiovascular disease, or myocardial infarction within 12 months before enrollment; severe neurological or psychiatric history; severe infection; active disseminated intravascular coagulation.
- Hypoproteinemia.
- Preprandial blood glucose control exceeds 11.2mmol/L in the week before surgery.
- BMI>28 kg/m^2.
- Poor compliance, and failure to comply with the study protocol.
- Subject withdrawal from the study
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Sentinel Lymph Node Biopsy
The fluorescence laparoscope was used to visualize and locate the sentinel lymph node, which was then removed.
|
After the total mesorectal excision, the indocyanine green was injected around the tumor via the anus.
The fluorescence laparoscope was used to visualize and locate the sentinel lymph node, which was then removed and sent for rapid frozen pathological examination.
Subsequently, a lateral lymph node dissection was performed.
Other Names:
Indocyanine green was injected around the tumor via the anus to visualize the sentinel lymph nodes under the fluorescence laparoscope.
Other Names:
The fluorescence laparoscope was used to visualize and locate the sentinel lymph node.
The surgical specimens and sentinel lymph nodes were routinely examined for pathology.
The lateral green fluorescence imaging sentinel lymph nodes found during surgery was sent to make cryosections.
And then a pathologist makes a rapid diagnosis under a microscope。
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
False negative rate
Time Frame: up to 14 days
|
The false negative rate of predicting lateral lymph node metastasis status using rapid frozen pathology results of lateral sentinel lymph nodes in mid-to-low rectal cancer. Namely, the false negative rate= total false negative cases/(total false negative cases+total true positive cases). |
up to 14 days
|
Accuracy
Time Frame: up to 14 days
|
The accuracy of predicting lateral lymph node metastasis status using rapid frozen pathology results of lateral sentinel lymph nodes in mid-to-low rectal cancer. Namely, the accuracy = (total true negative cases+total true positive cases)/total number of cases. |
up to 14 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Detection rate
Time Frame: up to 14 days
|
The detection rate of lateral sentinel lymph nodes in middle and low rectal cancer. Namely, the detection rate = (total true positive cases+total false positive cases)/total number of cases. |
up to 14 days
|
Specificity
Time Frame: up to 14 days
|
The specificity of predicting lateral lymph node metastasis status using rapid frozen pathology results of lateral sentinel lymph nodes in mid-to-low rectal cancer. Namely, the specificity = total true negative cases/(total true negative cases+total false positive cases). |
up to 14 days
|
Sensitivity
Time Frame: up to 14 days
|
The Sensitivity of predicting lateral lymph node metastasis status using rapid frozen pathology results of lateral sentinel lymph nodes in mid-to-low rectal cancer. Namely, the sensitivity= total true positive cases/(total true positive cases+total false negative cases)。 |
up to 14 days
|
Collaborators and Investigators
Sponsor
Investigators
- Study Chair: Haitao Zhou, M.D., National Cancer Center, China
Study record dates
Study Major Dates
Study Start (Anticipated)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SLNB
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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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