Feasibility Study to Develop Sentinel Lymph Node Mapping in Rectal Cancer Patients
Novel Sentinel Lymph Node Mapping Technique in Early Stage Rectal Cancer
The purpose of this study is to see if investigators can develop a technique to identify sentinel lymph nodes in the rectum for rectal cancer patients with the use of a radiotracer (Tc-sulfur colloid), a dye (Spot), and imaging, both pre- and intraoperatively. Eligible patients are those with stage I-III rectal cancer undergoing standard low anterior resection or abdominoperineal resection.
Investigators hypothesize that use of a unique intraoperative lymphatic mapping technique using a mobile gamma camera will identify the sentinel lymph node in patients with rectal cancer with greater than 80% sensitivity.
Subjects will receive injections of the tracer and dye prior to surgery, have preoperative SPECT/CT imaging to be used as a guide to the rectal lymphatic system and then proceed to their scheduled surgery. During surgery, images of the rectum will be taken with a unique mobile gamma camera prior to removal and upon resection.
If surgeons are able to identify the sentinel lymph nodes surrounding the rectal tumor, the hope is to combine this technique with a less invasive surgery called transanal endoscopic microsurgery (TEM) for early stage rectal cancer patients.
Aperçu de l'étude
Statut
Les conditions
Type d'étude
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Virginia
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Charlottesville, Virginia, États-Unis, 22908
- University of Virginia
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
Accepte les volontaires sains
Sexes éligibles pour l'étude
La description
Inclusion Criteria:
- Adult patients with stage I,II, or III rectal cancer undergoing standard trans- abdominal low anterior resection or abdominoperineal resection surgery at the University of Virginia
- Willing and able to give written informed consent
Exclusion Criteria:
- Patients less than 18 years of age
- Women who are pregnant and/or breastfeeding
- Prisoners
- Unable to give written informed consent
- Participants with medical contradictions or have potential problems complying with the requirements of the protocol, in the opinion of the investigator
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Diagnostique
- Répartition: N / A
- Modèle interventionnel: Affectation à un seul groupe
- Masquage: Aucun (étiquette ouverte)
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Surgery with pre- and intra-op imaging
Subjects will have a preoperative flexible sigmoidoscopy where they will receive an endoscopic injection of 99mTc-sulfur colloid (up to 0.5 mCi) and 3 to 5 cc of circumferential endoscopic injections of Spot.
A SPECT/CT will be performed prior to surgery to identify lymph nodes in the rectum.
Subjects will proceed to their standard surgery.
Intraoperative mobile gamma camera imaging of the rectum will occur before and after resection in attempt to identify sentinel lymph nodes.
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Intraoperative images will be taken with a unique mobile gamma camera to identify sentinel lymph nodes in the rectum.
Radiotracer injection around the rectal tumor for pre- and intra-operative imaging.
Autres noms:
Dye injection for tattooing rectal tumor prior to surgical resection.
Flexible sigmoidoscopy prior to surgery to facilitate endoscopic injections of radiotracer and dye.
Preoperative imaging to identify lymph nodes in rectum.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Evaluating the sensitivity of identifying the sentinel lymph node using a unique mobile gamma camera intraoperatively.
Délai: At the time of surgery and the time of pathological review, an expected average of 7 days.
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The primary endpoint is the sensitivity of sentinel lymph node (SLN) detection by the technique which will be estimated by the number of SLNs detected by the technique divided by the number noted at surgery or on final pathology review.
90% confidences interval around the estimate will help guide interpretation of the results.
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At the time of surgery and the time of pathological review, an expected average of 7 days.
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Feasibility
Délai: From the time of tracer and dye injections to 30 day postoperative visit
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Descriptive summaries will be used to list any complications that may have occurred pre-, intra- or post-operatively.
Frequency and location of the sentinel lymph node (SLN) with respect to the tumor prior to surgery will be noted.
In addition the location of the SLN in relation to the tumor will be documented during pathologic examination with the pathologist and surgeon to assess the feasibility of excision with transanal endoscopic microsurgery.
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From the time of tracer and dye injections to 30 day postoperative visit
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Traci L Hedrick, MD, University of Virginia
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude
Achèvement primaire (Anticipé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Estimation)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Estimation)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 16746
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