Carbon Nanoparticles as Lymph Node Tracer in Rectal Cancer After Neoadjuvant Radiochemotherapy

NCT ID: NCT03550001

Last Updated: 2018-06-08

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

252 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-06-01

Study Completion Date

2023-10-01

Brief Summary

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The purpose of this study is to evaluate whether injection of carbon nanoparticle as a lymph node tracer before neoadjuvant radiochemotherapy in rectal cancer can increase lymph node yield after surgery compared which do not inject.

Detailed Description

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This is the randomized controlled, multi-centers,and open-labeled study. The lymph node yield was significantly decreased in rectal cancer after neoadjuvant radiochemotherapy (NAT), hard for pathologists to detect, and is difficult to meet the guideline that minimun of 12 lymph nodes should be retrived after surgery in colorectal cancer. Carbon nanoparticle (CNP) is a specific lymph node tracer, which only dyeing the lymph node, and can keep the lymph node in dyeing state in at least half year. The inverstigator attempted to compare the amount of lymph node yield after surgery in locally advanced rectal caner between injection CNP before NAT and no injection CNP before NAT. In this study, the participants with clinical TNM stage T3+ or N+ will be recruited. The participants will be randomized (1:1 ratio) to a control and intervention arm. The participants in the control arm will not receive injection of any kind lymph node tracers. The participants in the intervention arm will receive injection of CNP before NAT. And the specimen would be evaluated by the pathologist.

Conditions

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Rectal Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Parallel
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Open label

Study Groups

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Injection CNP before NAT

Inject carbon nanoparticle as a lymph node tracer before the patient receive neoadjuvant therapy.

Group Type EXPERIMENTAL

Injection CNP before NAT

Intervention Type PROCEDURE

Injection carbon nanoparticle via rectal mucosa before neoadjuvant therapy

No injection

Do not inject carbon nanoparticle during the treatment.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Injection CNP before NAT

Injection carbon nanoparticle via rectal mucosa before neoadjuvant therapy

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Age: 18-75 years old;
2. Histologically confirmed adenocarcinoma;
3. The rectal adenocarcinoma 0-12cm from the anal margin;
4. Clinical TNM stage: T3+ or N+;
5. Untreated patients (who have not received treatment including radiotherapy, chemotherapy, and surgery);
6. Good liver and kidney function, without contraindications for radiotherapy, chemotherapy or surgery;
7. Able and willing to give informed consent to participate;

Exclusion Criteria

1. Malignant tumor history or other malignant tumors;
2. Emergency operations such as intestinal obstruction, perforation and hemorrhage;
3. Pregnant or lactating women;
4. History of severe mental illness;
5. Contraindications for radiotherapy, chemotherapy and surgery;
6. Conditions that the researcher thinks it is not suitable for selection.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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YE Yingjiang

OTHER

Sponsor Role lead

Responsible Party

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YE Yingjiang

Professor of Surgery, Director of Department of Gastroenterological Surgery

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Yingjiang Ye, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

Peking University People's Hospital

Central Contacts

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Yingjiang Ye, MD,PhD

Role: CONTACT

Zhidong Gao, MD

Role: CONTACT

8610-88326605

References

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Glynne-Jones R, Wyrwicz L, Tiret E, Brown G, Rodel C, Cervantes A, Arnold D; ESMO Guidelines Committee. Rectal cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017 Jul 1;28(suppl_4):iv22-iv40. doi: 10.1093/annonc/mdx224. No abstract available.

Reference Type BACKGROUND
PMID: 28881920 (View on PubMed)

Mechera R, Schuster T, Rosenberg R, Speich B. Lymph node yield after rectal resection in patients treated with neoadjuvant radiation for rectal cancer: A systematic review and meta-analysis. Eur J Cancer. 2017 Feb;72:84-94. doi: 10.1016/j.ejca.2016.10.031. Epub 2016 Dec 24.

Reference Type BACKGROUND
PMID: 28027520 (View on PubMed)

Gurawalia J, Dev K, Nayak SP, Kurpad V, Pandey A. Less than 12 lymph nodes in the surgical specimen after neoadjuvant chemo-radiotherapy: an indicator of tumor regression in locally advanced rectal cancer? J Gastrointest Oncol. 2016 Dec;7(6):946-957. doi: 10.21037/jgo.2016.09.03.

Reference Type BACKGROUND
PMID: 28078118 (View on PubMed)

Kim HJ, Jo JS, Lee SY, Kim CH, Kim YJ, Kim HR. Low Lymph Node Retrieval After Preoperative Chemoradiation for Rectal Cancer is Associated with Improved Prognosis in Patients with a Good Tumor Response. Ann Surg Oncol. 2015;22(6):2075-81. doi: 10.1245/s10434-014-4235-z. Epub 2014 Nov 14.

Reference Type BACKGROUND
PMID: 25395150 (View on PubMed)

Xu Z, Berho ME, Becerra AZ, Aquina CT, Hensley BJ, Arsalanizadeh R, Noyes K, Monson JRT, Fleming FJ. Lymph node yield is an independent predictor of survival in rectal cancer regardless of receipt of neoadjuvant therapy. J Clin Pathol. 2017 Jul;70(7):584-592. doi: 10.1136/jclinpath-2016-203995. Epub 2016 Dec 8.

Reference Type BACKGROUND
PMID: 27932667 (View on PubMed)

Lykke J, Jess P, Roikjaer O; Danish Colorectal Cancer Group. A minimum yield of twelve lymph nodes in rectal cancer remains valid in the era of neo-adjuvant treatment : results from a national cohort study. Int J Colorectal Dis. 2015 Mar;30(3):347-51. doi: 10.1007/s00384-015-2145-6. Epub 2015 Feb 5.

Reference Type BACKGROUND
PMID: 25652878 (View on PubMed)

Lykke J, Jess P, Roikjaer O; Danish Colorectal Cancer Group. Increased Lymph Node Yield Is Associated With Improved Survival in Rectal Cancer Irrespective of Neoadjuvant Treatment: Results From a National Cohort Study. Dis Colon Rectum. 2015 Sep;58(9):823-30. doi: 10.1097/DCR.0000000000000429.

Reference Type BACKGROUND
PMID: 26252843 (View on PubMed)

Bhangu A, Kiran RP, Brown G, Goldin R, Tekkis P. Establishing the optimum lymph node yield for diagnosis of stage III rectal cancer. Tech Coloproctol. 2014 Aug;18(8):709-17. doi: 10.1007/s10151-013-1114-8. Epub 2014 Feb 11.

Reference Type BACKGROUND
PMID: 24515286 (View on PubMed)

Carvalho C, Glynne-Jones R. Challenges behind proving efficacy of adjuvant chemotherapy after preoperative chemoradiation for rectal cancer. Lancet Oncol. 2017 Jun;18(6):e354-e363. doi: 10.1016/S1470-2045(17)30346-7.

Reference Type BACKGROUND
PMID: 28593861 (View on PubMed)

Horne J, Carr NJ, Bateman AC, Kandala N 2nd, Adams J, Silva S, Ryder I. A comparison of formalin and GEWF in fixation of colorectal carcinoma specimens: rates of lymph node retrieval and effect on TNM staging. J Clin Pathol. 2016 Jun;69(6):511-7. doi: 10.1136/jclinpath-2015-203281. Epub 2015 Nov 30.

Reference Type BACKGROUND
PMID: 26621110 (View on PubMed)

Yegen G, Keskin M, Buyuk M, Kunduz E, Balik E, Saglam EK, Kapran Y, Asoglu O, Gulluoglu M. The effect of neoadjuvant therapy on the size, number, and distribution of mesorectal lymph nodes. Ann Diagn Pathol. 2016 Feb;20:29-35. doi: 10.1016/j.anndiagpath.2015.10.008. Epub 2015 Oct 29.

Reference Type BACKGROUND
PMID: 26706785 (View on PubMed)

Munster M, Hanisch U, Tuffaha M, Kube R, Ptok H. Ex Vivo Intra-arterial Methylene Blue Injection in Rectal Cancer Specimens Increases the Lymph-Node Harvest, Especially After Preoperative Radiation. World J Surg. 2016 Feb;40(2):463-70. doi: 10.1007/s00268-015-3230-2.

Reference Type BACKGROUND
PMID: 26310202 (View on PubMed)

Farinella E, Vigano L, Fava MC, Mineccia M, Bertolino F, Capussotti L. In vivo lymph node mapping and pattern of metastasis spread in locally advanced mid/low rectal cancer after neoadjuvant chemoradiotherapy. Int J Colorectal Dis. 2013 Nov;28(11):1523-9. doi: 10.1007/s00384-013-1727-4. Epub 2013 Jul 23.

Reference Type BACKGROUND
PMID: 23877264 (View on PubMed)

Zhang XM, Liang JW, Wang Z, Kou JT, Zhou ZX. Effect of preoperative injection of carbon nanoparticle suspension on the outcomes of selected patients with mid-low rectal cancer. Chin J Cancer. 2016 Apr 4;35:33. doi: 10.1186/s40880-016-0097-z.

Reference Type BACKGROUND
PMID: 27044280 (View on PubMed)

Wang Y, Deng H, Chen H, Liu H, Xue Q, Yan J, Li G. Preoperative Submucosal Injection of Carbon Nanoparticles Improves Lymph Node Staging Accuracy in Rectal Cancer after Neoadjuvant Chemoradiotherapy. J Am Coll Surg. 2015 Nov;221(5):923-30. doi: 10.1016/j.jamcollsurg.2015.07.455. Epub 2015 Aug 20.

Reference Type BACKGROUND
PMID: 26362137 (View on PubMed)

Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, de Santibanes E, Pekolj J, Slankamenac K, Bassi C, Graf R, Vonlanthen R, Padbury R, Cameron JL, Makuuchi M. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 2009 Aug;250(2):187-96. doi: 10.1097/SLA.0b013e3181b13ca2.

Reference Type BACKGROUND
PMID: 19638912 (View on PubMed)

Mandard AM, Dalibard F, Mandard JC, Marnay J, Henry-Amar M, Petiot JF, Roussel A, Jacob JH, Segol P, Samama G, et al. Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations. Cancer. 1994 Jun 1;73(11):2680-6. doi: 10.1002/1097-0142(19940601)73:113.0.co;2-c.

Reference Type BACKGROUND
PMID: 8194005 (View on PubMed)

Other Identifiers

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2017-PKUPH077

Identifier Type: -

Identifier Source: org_study_id

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