Feasibility Study to Develop Sentinel Lymph Node Mapping in Rectal Cancer Patients

NCT ID: NCT02112240

Last Updated: 2016-07-15

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

WITHDRAWN

Clinical Phase

NA

Study Classification

INTERVENTIONAL

Study Start Date

2013-05-31

Brief Summary

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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.

Detailed Description

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Conditions

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Rectal Cancer

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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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.

Group Type EXPERIMENTAL

Intraoperative Mobile Gamma Camera imaging

Intervention Type OTHER

Intraoperative images will be taken with a unique mobile gamma camera to identify sentinel lymph nodes in the rectum.

Endoscopic injection of 99mTc-sulfur colloid

Intervention Type DRUG

Radiotracer injection around the rectal tumor for pre- and intra-operative imaging.

Endoscopic injections of Spot

Intervention Type OTHER

Dye injection for tattooing rectal tumor prior to surgical resection.

Preoperative flexible sigmoidoscopy

Intervention Type PROCEDURE

Flexible sigmoidoscopy prior to surgery to facilitate endoscopic injections of radiotracer and dye.

SPECT/CT

Intervention Type RADIATION

Preoperative imaging to identify lymph nodes in rectum.

Interventions

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Intraoperative Mobile Gamma Camera imaging

Intraoperative images will be taken with a unique mobile gamma camera to identify sentinel lymph nodes in the rectum.

Intervention Type OTHER

Endoscopic injection of 99mTc-sulfur colloid

Radiotracer injection around the rectal tumor for pre- and intra-operative imaging.

Intervention Type DRUG

Endoscopic injections of Spot

Dye injection for tattooing rectal tumor prior to surgical resection.

Intervention Type OTHER

Preoperative flexible sigmoidoscopy

Flexible sigmoidoscopy prior to surgery to facilitate endoscopic injections of radiotracer and dye.

Intervention Type PROCEDURE

SPECT/CT

Preoperative imaging to identify lymph nodes in rectum.

Intervention Type RADIATION

Other Intervention Names

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Tc-sulfur colloid

Eligibility Criteria

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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
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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American Cancer Society, Inc.

OTHER

Sponsor Role collaborator

University of Virginia

OTHER

Sponsor Role lead

Responsible Party

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Traci Hedrick, MD

Assistant Professor of Surgery

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Traci L Hedrick, MD

Role: PRINCIPAL_INVESTIGATOR

University of Virginia

Locations

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University of Virginia

Charlottesville, Virginia, United States

Site Status

Countries

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United States

Other Identifiers

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16746

Identifier Type: -

Identifier Source: org_study_id

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