- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06133699
Sentinel Lymph Node Biopsy in Stage AI-IIA Germ Cell Tumors (PITERLAND)
A Prospective, Single-center, Clinical Trial to Evaluate the Efficacy of Sentinel Lymph Node Biopsy in Stage AI-IIA Germ Cell Tumors (Seminoma/Nonseminoma)(PITERLAND).
The goal of this clinical trial is to evaluate the efficacy of sentinel lymph node biopsy in stage AI-IIA germ cell tumors (seminoma/nonseminoma). The main questions it aims to answer are:
- To evaluate relapse-free survival during the first two years after SLNB.
- To estimate the percentage of patients who did not require adjuvant treatment after primary endoscopic SLNB.
- Determine the microRNA expression profile in blood plasma, evaluate miRNAs as a potential prognostic and predictive factor in patients with testicular germ cell tumors.
- Assess the correlation between computed tomography and positive lymph nodes on examination.
Participants will undergo:
- surgical treatment including orchofuniculectomy with simultaneous laparoscopic biopsy of the sentinel lymph node using indocyanine green dye with/without methylene blue dye.
- 24 hours before the procedure, a radiopharmaceutical (RP) is injected into the spermatic cord, followed by SPECT to determine the regional sentinel lymph node(s).
- The level of microRNA will be examined before surgery and 10 days after surgery.
Study Overview
Status
Conditions
Detailed Description
Research Design This study is a prospective, single-center, non-randomized study evaluating the role of primary endoscopic SLNB on progression-free survival in patients with stage I-II germ cell seminoma/non-seminoma tumor without adjuvant treatment. Additionally, the study will determine the prognostic value of miRNAs as a noninvasive marker in clinical practice.
This study plans to recruit 44 male patients with a preliminary diagnosis of testicular tumor.
Patients who meet the inclusion/exclusion criteria will undergo surgical treatment including orchofuniculectomy with a simultaneous assessment and biopsy of the sentinel retroperitoneal lymph node.
The first stage of treatment Pre-operative preparation At the preoperative stage, it is planned to perform 3D modeling of computed tomography slices to visualize tumor conglomerates and vascular topography. A map of lymph node dissection zones will also be compiled. The anatomical boundaries of lymph node dissection are the aorta, the inferior vena cava, the iliac vessels, their bifurcation zones, the renal and mesenteric vessels. Due to the distribution of lymph nodes into cohorts (from 1 to 9 in each case), further histological examination of the surgical material will assess the completeness of the performed lymph node dissection.
Radiopharmaceutical administration (Technetium/methylene blue) 24 hours before surgery, a radiotracer (RP) will be injected into the spermatic cord followed by SPECT to identify the regional sentinel lymph node(s).
Orchofuniculectomy Study participants will undergo orchofuniculectomy through an inguinal or laparoscopic approach.
After completion of the orchofuniculectomy, indocyanine green (ICG) dye with or without methylene blue dye will be injected into the spermatic cord stump.
Second stage of treatment Laparoscopic access and port placement
Under general anesthesia, with the patient in the supine position with arms extended along the body and legs spread apart, after processing the surgical field, laparoscopic ports will be installed under sterile conditions as follows:
- In the pubic region, 1 cm below the navel, an optical trocar is installed according to the Hasson technique (pneumoperitoneum (P=14 mmHg).
- Installation of trocars in the right iliac region, in the left iliac region and above the pubic symphysis (5, 5 and 11 mm, respectively).
The patient is then placed in the Trendelenburg position. BSLU Next, in the operating room, the surgeon will use a gamma detector to determine the location of the sentinel lymph nodes, followed by removal of one or more (up to 4) lymph nodes from which the signal is received. These lymph nodes will be sent for histological examination.
The results of the work performed will present indicators of relapse-free survival after SLNB, as well as functional outcomes, such as postoperative complications, duration of hospital treatment, frequency of retrograde ejaculation in patients with stage IA-IIA testicular germ cell tumor. The data obtained will allow optimizing the selection of patients for surgical treatment, as well as identifying prognostic factors for the adjuvant stage of therapy.
Additionally, as part of the work, it is planned to study the expression profile of microRNAs in blood plasma, with subsequent assessment as a potential prognostic and predictive factor in patients with germ cell tumors. For this purpose, blood will be drawn from patients before surgery and 10 days after surgery.
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Saint-Petersburg, Russian Federation, 197758
- Recruiting
- Federal State Budgetary Institute N.N. Petrov National Medical Research Center of Oncology Ministry of Health of the Russian Federation
-
Contact:
- Eldar Mamizhev, PhD (Med.), Oncologist
- Phone Number: +79217696923
- Email: mamijev@mail.ru
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Male person at least 18 years of age at the time of signing the informed consent form;
- Provisional diagnosis of testicular tumor with isolated retroperitoneal lymphadenopathy;
- Computed tomography data of the abdominal cavity and retroperitoneal space with axial visualization of lymphadenopathy (within 6 weeks before the planned date of surgical treatment): at least one lymph node larger than 1 cm.
Exclusion Criteria:
- Severe or uncontrolled concomitant chronic diseases or acute diseases;
- Any condition that, in the opinion of the physician, may limit compliance with the study;
- Poor general condition (ECOG > 2, KPS < 70);
- Refusal of the patient to comply with the study procedures or refusal of the patient to continue participating in the study;
- Development of diseases or conditions that prevent the patient's continued participation in the study;
- AFP level is higher than reference values and / or b-hCG > 100 mIU/ml;
- Presence of a second malignant disease;
- History of systemic antitumor therapy and/or radiotherapy;
- Inadequate bone marrow, liver, kidney function: (Neutrophils < 1.5 x 10^9/l, Platelets < 100 x 10^9/l, ALT > 3 x ULN, AST > 3 x ULN, Total bilirubin > 1.5 xULN, GFR <35 ml/min)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: SLNB
|
Study participants will undergo orchofuniculectomy through an inguinal or laparoscopic approach.
After completion of the orchofuniculectomy, indocyanine green (ICG) dye with or without methylene blue dye will be injected into the spermatic cord stump.
Next step is detection with a gamma detector the sentinel lymph nodes and follow removing of one or more (up to 4) lymph nodes during laparoscopy.
These lymph nodes will be sent for histological examination.
24 hours before surgery, a radiotracer (RP) will be injected into the spermatic cord followed by SPECT to identify the regional sentinel lymph node(s).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Relapse-free survival during the first two years after SLNB
Time Frame: two years
|
two years
|
The percentage of patients who did not require adjuvant treatment after primary endoscopic SLNB
Time Frame: two years
|
two years
|
Evaluation of miRNAs as a potential prognostic and prognostic factor in patients with testicular germ cell tumors.
Time Frame: two years
|
two years
|
• Assess the correlation between computed tomography and positive lymph nodes on examination.
Time Frame: two years
|
two years
|
Secondary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Сomplication rate
Time Frame: two years
|
two years
|
All-cause mortality
Time Frame: two years
|
two years
|
Collaborators and Investigators
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 (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 01112023-PITERLAND
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 Testicular Germ Cell Tumor
-
Royal Marsden NHS Foundation TrustUniversity College London (UCL) Cancer InstituteUnknownTesticular Germ Cell TumorUnited Kingdom
-
National Cancer Institute (NCI)TerminatedTesticular Seminoma | Recurrent Ovarian Germ Cell Tumor | Stage II Ovarian Germ Cell Tumor | Stage III Ovarian Germ Cell Tumor | Ovarian Dysgerminoma | Recurrent Malignant Testicular Germ Cell Tumor | Stage II Malignant Testicular Germ Cell Tumor | Stage III Malignant Testicular Germ Cell TumorUnited States
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedTesticular Yolk Sac Tumor | Recurrent Ovarian Germ Cell Tumor | Recurrent Childhood Malignant Germ Cell Tumor | Recurrent Malignant Testicular Germ Cell Tumor | Childhood Extracranial Germ Cell Tumor | Childhood Malignant Ovarian Germ Cell Tumor | Childhood Malignant Testicular Germ Cell Tumor | Ovarian... and other conditionsUnited States, Canada, Australia, Puerto Rico
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedChildhood Teratoma | Stage II Malignant Testicular Germ Cell Tumor | Stage III Malignant Testicular Germ Cell Tumor | Childhood Embryonal Tumor | Childhood Extracranial Germ Cell Tumor | Childhood Extragonadal Germ Cell Tumor | Childhood Malignant Ovarian Germ Cell Tumor | Childhood Malignant Testicular... and other conditionsUnited States, Canada, Australia, New Zealand, Puerto Rico, Switzerland
-
European Organisation for Research and Treatment...CompletedTesticular Germ Cell Tumor | Unspecified Adult Solid Tumor, Protocol SpecificFrance, Netherlands, Norway, Belgium, Switzerland, Austria, United Kingdom, Germany, Denmark
-
Memorial Sloan Kettering Cancer CenterNational Cancer Institute (NCI); Eastern Cooperative Oncology Group; Southwest... and other collaboratorsCompletedTesticular Germ Cell Tumor | Extragonadal Germ Cell Tumor | Childhood Germ Cell TumorUnited States, Puerto Rico, Australia, Peru
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedTesticular Seminoma | Testicular Yolk Sac Tumor | Childhood Malignant Ovarian Germ Cell Tumor | Childhood Malignant Testicular Germ Cell Tumor | Ovarian Embryonal Carcinoma | Ovarian Yolk Sac Tumor | Testicular Embryonal Carcinoma | Ovarian Choriocarcinoma | Ovarian Mixed Germ Cell Tumor | Testicular Choriocarcinoma and other conditionsUnited States
-
University of Texas Southwestern Medical CenterActive, not recruitingTesticular Germ Cell Tumor | Testicular Neoplasms | Testicular Diseases | Testis Cancer | Testicular Cancer | Germ Cell Tumor | Testicular Yolk Sac Tumor | Testicular Choriocarcinoma | Germ Cell Tumor of Testis | Germ Cell Tumor, Testicular, Childhood | Germ Cell Cancer Metastatic | Germ Cell Neoplasm of Retroperitoneum and other conditionsUnited States
-
European Organisation for Research and Treatment...UnknownTesticular Germ Cell Tumor | Teratoma | Extragonadal Germ Cell TumorFrance, Netherlands, Spain, United Kingdom, Norway, Belgium, Germany, Denmark, Hungary, Slovakia, Israel, Italy, Austria, Poland
-
Children's Oncology GroupNational Cancer Institute (NCI)CompletedTesticular Germ Cell Tumor | Ovarian Cancer | Extragonadal Germ Cell Tumor | Childhood Germ Cell Tumor
Clinical Trials on Orchofuniculectomy with simultaneous laparoscopic biopsy of the sentinel lymph node using indocyanine green dye with/without methylene blue dye.
-
University of Southern CaliforniaNational Cancer Institute (NCI)TerminatedLymphedema | Stage II Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Recurrent Breast CancerUnited States
-
Centre Oscar LambretInstitut National de la Santé Et de la Recherche Médicale, France; National... and other collaboratorsActive, not recruiting
-
Memorial Sloan Kettering Cancer CenterCompletedBreast Cancer | Axillary Lymph Node DissectionUnited States