Surgical Staging in Cervical Cancer Prior to Chemoradiation

NCT ID: NCT01049100

Last Updated: 2010-01-15

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

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-04-30

Study Completion Date

2017-04-30

Brief Summary

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The aim of this study is to determine whether the modified therapy on the basis of operative staging and systematic, pelvine and paraaortal lymphadenectomy for patients with cervical cancer of the FIGO stages IIB-IV prior to introducing radio-chemotherapy leads to a significant improvement of disease-free survival.

Detailed Description

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The aim of this study is to determine whether the modified therapy on the basis of operative staging and systematic, pelvine and paraaortal lymphadenectomy for patients with cervical cancer of the FIGO stages IIB-IV prior to introducing radio-chemotherapy leads to a significant improvement of disease-free survival.

To this end, 250 patients with histologically verified cancer of the cervix uteri of the stages IIB-IV shall be randomised to a standard arm (ARM B), whereby the therapy shall be conducted on the basis of the clinical FIGO stage.

The patients randomised to the test arm (Arm A), after determining the clinical FIGO stage, shall initially receive an operative staging in the form of a pelvine paraaortal lymphadenectomy (laparoscopic or open). On the basis of the operatively obtained findings, a ("surgically") modified tumour stage shall be determined. This "surgical" tumour stage, which shall take into account the affection of the lymph nodes, the infiltration of the neighbouring organs and the intraperitoneal spread, shall serve as the basis for the execution of primary, combined radio-chemotherapy. The primary end-point is the disease-free survival of both groups, the secondary endpoints are overall survival, the local control of both groups, as well as the determination of toxicity and the quality of life.

Conditions

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Cervical Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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operative staging (A)

operative staging and systemic lymphadenectomy, paraaortal and pelvine, laparoscopic or open

Group Type EXPERIMENTAL

lymphadenectomy

Intervention Type PROCEDURE

paraaortal and pelvic lymphadenectomy laparoscopic or open

Standard (B)

No surgical intervention. Clinical Staging (FIGO) CT Abdomen / pelvic enlarged or suspicious lymphnodes--\> CT controlled biopsy and histological analysis.

Group Type NO_INTERVENTION

Standard Staging

Intervention Type OTHER

clinical Staging (FIGO) (examination in narcosis, biopsy, cystoscopy, rectoscopy) X-Ray Radiograph of Thorax, Ultrasound of abdomen, CT abdomen / pelvis positive, suspicious lymphnodes--\> CT controlled biopsy

Interventions

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lymphadenectomy

paraaortal and pelvic lymphadenectomy laparoscopic or open

Intervention Type PROCEDURE

Standard Staging

clinical Staging (FIGO) (examination in narcosis, biopsy, cystoscopy, rectoscopy) X-Ray Radiograph of Thorax, Ultrasound of abdomen, CT abdomen / pelvis positive, suspicious lymphnodes--\> CT controlled biopsy

Intervention Type OTHER

Other Intervention Names

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debulking, surgical staging FIGO Staging

Eligibility Criteria

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Inclusion Criteria

* Karnofsky-Index =/\> 70,
* age between 18 - 70 years
* histological assured cervical cancer (by biopsy)
* FIGO stages II B - IV
* written informed consent
* patient's ability to cooperate

Exclusion Criteria

* neuroendocrine tumors or histological mixed types containing neuroendocrine fractions
* pregnancy, lactation,
* distant metastases, except paraaortal metastases
* other malignant diseases in anamnesis
* pelvic radiotherapy in anamnesis
* severe internal diseases
* psychiatric diseases which might query the trial attendance or follow-up
* HIV-Infection or AIDS
* drug addiction
* existing motoric or sensoric polyneuropathy \> CTC Grad 1
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Deutsche Krebshilfe e.V., Bonn (Germany)

OTHER

Sponsor Role collaborator

Arbeitsgemeinschaft Radiologische Onkologie

OTHER

Sponsor Role collaborator

Charite University, Berlin, Germany

OTHER

Sponsor Role lead

Responsible Party

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Department of Radiooncology (Charité Campus Mitte und Virchow) / Department of Gynaecology (Charité Campus Mitte und Benjamin Franklin)

Principal Investigators

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Simone Marnitz, PD

Role: STUDY_CHAIR

Department of Radiooncology (Charité Campus Mitte und Virchow), Charitéplatz 1, 10117 Berlin, Germany

Christhardt Köhler, Prof.

Role: STUDY_CHAIR

Department of Gynaecology (Charité Campus Mitte und Benjamin Franklin), Charitéplatz 1, 10117 Berlin, Germany

Anja Dittgen

Role: PRINCIPAL_INVESTIGATOR

Department of Gynaecology (Charité Campus Mitte), Charitéplatz 1, 10117 Berlin, Germany

Locations

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Department of Gynaecology, Charité Campus Mitte und Benjamin Franklin

Berlin, , Germany

Site Status RECRUITING

Department of Radiooncology, Charité Campus Mitte und Campus Virchow

Berlin, , Germany

Site Status RECRUITING

Countries

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Germany

Central Contacts

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Simone Marnitz, PD

Role: CONTACT

004930450627162

Facility Contacts

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Christhardt Köhler, Professor

Role: primary

004930450564091

Anja Dittgen

Role: backup

004930450664434

Simone Marnitz, PD

Role: primary

004930450527162

Anja Dittgen

Role: backup

004930450664434

References

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Sakuragi N. Up-to-date management of lymph node metastasis and the role of tailored lymphadenectomy in cervical cancer. Int J Clin Oncol. 2007 Jun;12(3):165-75. doi: 10.1007/s10147-007-0661-2. Epub 2007 Jun 27.

Reference Type BACKGROUND
PMID: 17566838 (View on PubMed)

Subak LL, Hricak H, Powell CB, Azizi L, Stern JL. Cervical carcinoma: computed tomography and magnetic resonance imaging for preoperative staging. Obstet Gynecol. 1995 Jul;86(1):43-50. doi: 10.1016/0029-7844(95)00109-5.

Reference Type BACKGROUND
PMID: 7784021 (View on PubMed)

Marnitz S, Kohler C, Roth C, Fuller J, Bischoff A, Wendt T, Schneider A, Budach V. Stage-adjusted chemoradiation in cervical cancer after transperitoneal laparoscopic staging. Strahlenther Onkol. 2007 Sep;183(9):473-8. doi: 10.1007/s00066-007-1675-4.

Reference Type BACKGROUND
PMID: 17762920 (View on PubMed)

Bye A, Trope C, Loge JH, Hjermstad M, Kaasa S. Health-related quality of life and occurrence of intestinal side effects after pelvic radiotherapy--evaluation of long-term effects of diagnosis and treatment. Acta Oncol. 2000;39(2):173-80. doi: 10.1080/028418600430734.

Reference Type BACKGROUND
PMID: 10859007 (View on PubMed)

Nag S, Erickson B, Thomadsen B, Orton C, Demanes JD, Petereit D. The American Brachytherapy Society recommendations for high-dose-rate brachytherapy for carcinoma of the cervix. Int J Radiat Oncol Biol Phys. 2000 Aug 1;48(1):201-11. doi: 10.1016/s0360-3016(00)00497-1.

Reference Type BACKGROUND
PMID: 10924990 (View on PubMed)

Lai CH, Huang KG, Hong JH, Lee CL, Chou HH, Chang TC, Hsueh S, Huang HJ, Ng KK, Tsai CS. Randomized trial of surgical staging (extraperitoneal or laparoscopic) versus clinical staging in locally advanced cervical cancer. Gynecol Oncol. 2003 Apr;89(1):160-7. doi: 10.1016/s0090-8258(03)00064-7.

Reference Type BACKGROUND
PMID: 12694671 (View on PubMed)

Denschlag D, Gabriel B, Mueller-Lantzsch C, Tempfer C, Henne K, Gitsch G, Hasenburg A. Evaluation of patients after extraperitoneal lymph node dissection for cervical cancer. Gynecol Oncol. 2005 Mar;96(3):658-64. doi: 10.1016/j.ygyno.2004.08.053.

Reference Type BACKGROUND
PMID: 15721408 (View on PubMed)

Related Links

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http://www.degro.org

Association for Radiooncology

Other Identifiers

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108771

Identifier Type: -

Identifier Source: org_study_id

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