PET/CT and Lymph Node Mapping in Finding Lymph Node Metastasis in Patients With High-Risk Endometrial Cancer

NCT ID: NCT01737619

Last Updated: 2025-11-28

Study Results

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Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

NA

Total Enrollment

101 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-04-03

Study Completion Date

2025-12-31

Brief Summary

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This clinical trial studies positron emission tomography (PET)/computed tomography (CT) and lymph node mapping in finding lymph node metastasis in patients with endometrial cancer that is at high risk of spreading. A PET/CT scan is a procedure that combines the pictures from a PET scan and a CT scan, which are taken at the same time from the same machine. The combined scans give more detailed pictures of areas inside the body than either scan gives by itself. Lymph node mapping uses a radioactive dye, called indocyanine green solution, to identify lymph nodes that may contain cancer cells. PET/CT and sentinel lymph node mapping may be better ways than surgery to identify cancer in the lymph nodes.

Detailed Description

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PRIMARY OBJECTIVES:

I. To estimate the false negative rate of PET/CT and/or sentinel lymph node mapping in the detection of positive lymph nodes in women with high risk endometrial cancers.

SECONDARY OBJECTIVES:

I. To estimate the sensitivity, specificity, positive predictive value, and negative predictive value of PET/CT and/or sentinel lymph node mapping in the detection of positive lymph nodes in women with high risk endometrial cancer.

II. To determine if a molecular panel of estrogen-induced genes that we have previously identified from retrospective studies correlate with extra-uterine spread including lymph node metastasis at the time of surgical staging for endometrial cancer.

III. To prospectively identify patterns of lymphatic spread of endometrial cancer.

IV. To correlate cancer antigen 125 (CA-125) and WAP four-disulfide core domain 2 (HE4) levels with disease metastasis at the time of surgical staging and to explore the use of other serum biomarkers to predict recurrence.

V. To prospectively collect morbidity and mortality data related to performing lymph node dissection including intra-operative and postoperative complications.

VI. To determine whether metabolic parameters of the primary endometrial tumor on PET including tumor intensity (maximum standard uptake value \[SUV\] and peak SUV), metabolic tumor volume (obtained at a threshold of 40% of maximum and at a threshold of SUV=3), and total lesion glycolysis (expressed average SUV over the metabolic tumor volume) are predictive of locoregional or metastatic spread, and whether these parameters correlate with CA-125 and HE4 levels.

OUTLINE:

Patients undergo PET/CT prior to surgery. Patients then undergo intraoperative lymph node mapping with indocyanine green solution, given via superficial and deep cervical injection during full lymphadenectomy.

Conditions

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Endometrial Clear Cell Adenocarcinoma Endometrial Mixed Adenocarcinoma Endometrial Serous Adenocarcinoma Grade 3 Endometrial Endometrioid Adenocarcinoma Malignant Mixed Mesodermal (Mullerian) Tumor

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Diagnostic (PET/CT, lymph node mapping)

Patients undergo PET/CT prior to surgery. Patients then undergo intraoperative lymph node mapping with indocyanine green solution, given via superficial and deep cervical injection during full lymphadenectomy.

Group Type EXPERIMENTAL

Computed Tomography

Intervention Type PROCEDURE

Undergo PET/CT

Indocyanine Green Solution

Intervention Type DRUG

Given via superficial and deep cervical injection

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Lymph Node Mapping

Intervention Type PROCEDURE

Undergo lymph node mapping

Lymphadenectomy

Intervention Type PROCEDURE

Undergo full lymphadenectomy

Positron Emission Tomography

Intervention Type PROCEDURE

Undergo PET/CT

Interventions

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Computed Tomography

Undergo PET/CT

Intervention Type PROCEDURE

Indocyanine Green Solution

Given via superficial and deep cervical injection

Intervention Type DRUG

Laboratory Biomarker Analysis

Correlative studies

Intervention Type OTHER

Lymph Node Mapping

Undergo lymph node mapping

Intervention Type PROCEDURE

Lymphadenectomy

Undergo full lymphadenectomy

Intervention Type PROCEDURE

Positron Emission Tomography

Undergo PET/CT

Intervention Type PROCEDURE

Other Intervention Names

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CAT CAT Scan Computerized Axial Tomography computerized tomography CT CT SCAN tomography IC-GREEN ICG Solution lymphatic mapping excision of the lymph node Lymph Node Dissection lymph node excision Medical Imaging, Positron Emission Tomography PET PET Scan Positron Emission Tomography Scan Positron-Emission Tomography proton magnetic resonance spectroscopic imaging

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed high grade endometrial cancer including grade 3 endometroid, serous, clear cell, malignant mixed Mullerian tumor (MMMT) or any mixed tumor containing one of these cell types
* Patients with a grade 1/2 tumors and evidence of deep myometrial invasion or cervical involvement on preoperative imaging or physical exam
* Candidate for surgery
* No evidence of peritoneal disease on preoperative imaging
* Negative pregnancy test if of child-bearing age
* No preoperative treatment for endometrial cancer including radiation or chemotherapy
* Previous hormonal therapy is allowed

Exclusion Criteria

* Medical co-morbidities making surgery unsafe, as determined by the primary treating physician
* Any contraindications to PET/CT or lymph node mapping (inability to control serum glucose to a value of =\< 200 mg/dl for fludeoxyglucose F-18 \[FDG\]-PET/CT)
* Does not meet histologic criteria
* Evidence of peritoneal or distant metastasis on preoperative imaging
* Baseline creatinine (necessary for imaging studies)
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pamela Soliman

Role: PRINCIPAL_INVESTIGATOR

M.D. Anderson Cancer Center

Locations

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Lyndon Baines Johnson General Hospital

Houston, Texas, United States

Site Status

M D Anderson Cancer Center

Houston, Texas, United States

Site Status

The Woman's Hospital of Texas

Houston, Texas, United States

Site Status

MD Anderson Regional Care Center-Katy

Houston, Texas, United States

Site Status

MD Anderson Regional Care Center-Bay Area

Nassau Bay, Texas, United States

Site Status

MD Anderson Regional Care Center-Sugar Land

Sugar Land, Texas, United States

Site Status

MD Anderson Regional Care Center-The Woodlands

The Woodlands, Texas, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Related Links

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http://www.mdanderson.org

MD Anderson Cancer Center Website

Other Identifiers

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NCI-2015-01898

Identifier Type: REGISTRY

Identifier Source: secondary_id

2012-0623

Identifier Type: OTHER

Identifier Source: secondary_id

P50CA098258

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2012-0623

Identifier Type: -

Identifier Source: org_study_id

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