Lymphatic Mapping, Sentinel Lymph Node Analysis, and Blood Tests in Detecting and Predicting Early Micrometastases in Patients With Colorectal Cancer

NCT ID: NCT00625625

Last Updated: 2013-09-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE2

Total Enrollment

225 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-03-31

Brief Summary

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RATIONALE: Diagnostic procedures, such as lymph node mapping during surgery and sentinel lymph node biopsy, may help doctors find micrometastases and predict cancer recurrence.

PURPOSE: This phase II trial is studying how well lymph node mapping during surgery together with sentinel lymph node analysis and blood testing work in detecting and predicting early micrometastases in patients with colorectal cancer.

Detailed Description

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OBJECTIVES:

* To determine the accuracy and sensitivity of intraoperative lymph node mapping with isosulfan blue and sentinal node biopsy (SLN) in patients with colorectal cancer (CRC).
* To compare molecular and immunohistochemical methods for detection of micrometastases in the SLN and primary tumor and evaluate the clinical outcome.
* To evaluate the clinicopathological utility of hematogenous micrometastases in predicting disease recurrence in CRC.

OUTLINE: Patients receive isosulfan blue subserosally around the primary tumor for sentinel lymph node (SLN) identification and SLN(s) are marked. Patients undergo a standard colon resection as planned to include the SLN(s) and regional lymph nodes.

Lymph nodes removed during surgery are analyzed within 30 days after surgery. Routine pathologic analysis (H\&E) are performed on all lymph nodes (SLN and non-SLN) removed. Immunohistochemical (IHC) staining for cytokeratin antibodies AE-1/AE-3 or MAK-6 are performed on all lymph nodes negative by H\&E. Multimarker PCR (MM PCR) are performed on all SLNs. Blood samples are collected at baseline and then periodically for 4 years for MM PCR to detect circulating tumor cells and standard tumor markers (e.g., CEA).

After surgery, patients are followed every 6 months for 4 years.

Conditions

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Colorectal Cancer

Keywords

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stage I colon cancer stage II colon cancer stage III colon cancer stage I rectal cancer stage II rectal cancer stage III rectal cancer

Study Design

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Primary Study Purpose

DIAGNOSTIC

Interventions

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isosulfan blue

Intervention Type DRUG

polymerase chain reaction

Intervention Type GENETIC

diagnostic laboratory biomarker analysis

Intervention Type OTHER

immunohistochemistry staining method

Intervention Type OTHER

diagnostic lymphadenectomy

Intervention Type PROCEDURE

therapeutic conventional surgery

Intervention Type PROCEDURE

therapeutic lymphadenectomy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* No discovery of distant metastases intra-operatively

PATIENT CHARACTERISTICS:

* ECOG performance status (PS) or Zubrod PS equal to 2
* Life expectancy \> 5 years not including the disease/diagnosis of colorectal cancer
* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* No requirement for emergent surgery (within 2 hours of presentation) to prevent a life-threatening situation or death including:

* Perforated colon
* Metabolically significant complete bowel obstruction
* Massive GI bleeding
* Occult bleeding or early or partial bowel obstruction not requiring emergent surgery allowed
* No history of Crohn disease, chronic ulcerative colitis, or familial polyposis
* No other malignancy within the past 3 years except for completely resected cervical cancer, skin cancer, or in situ cancer

PRIOR CONCURRENT THERAPY:

* See Disease Characteristics
* See Patient Characteristics
* No concurrent participation in another research protocol

* Participation during follow up allowed
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

Saint John's Cancer Institute

OTHER

Sponsor Role lead

Principal Investigators

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Shamim Baker

Role:

Saint John's Cancer Institute

Other Identifiers

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JWCI-GULS-CRCSLN-0104

Identifier Type: -

Identifier Source: secondary_id

CDR0000586464

Identifier Type: -

Identifier Source: org_study_id