Prediction of Recurrence Among Low Risk Endometrial Cancer Patients

NCT ID: NCT04604613

Last Updated: 2025-08-21

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

ACTIVE_NOT_RECRUITING

Total Enrollment

518 participants

Study Classification

OBSERVATIONAL

Study Start Date

2012-11-08

Study Completion Date

2026-12-31

Brief Summary

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This study investigates whether molecular testing can help to predict the risk of endometrial cancer coming back (recurrence) after treatment in patients diagnosed with low risk endometrial cancer and scheduled to have surgery to remove the uterus and/or cervix (hysterectomy). Having sentinel lymph node mapping performed may help researchers to see if the cancer has spread in patients with low risk endometrial cancer.

Detailed Description

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PRIMARY OBJECTIVE:

I. Validate the use of a molecular panel of estrogen-induced genes to predict recurrence in low risk endometrial cancer.

SECONDARY OBJECTIVES:

I. Calculate the positive predictive value (PPV)/negative predictive value (NPV)/sensitivity (Sens)/specificity (Spec) of lymph node mapping to predict pelvic lymph node involvement.

II. Correlate CA125 and HE4 levels with recurrence and to explore the use of other serum biomarkers to predict recurrence.

III. Describe patterns of recurrence in a low risk patient population. IV. Determine if molecular panel can predict lymph node involvement in low risk endometrial cancer patients who undergo pelvic and para-aortic lymphadenectomy.

V. Compare performance of molecular panel to the Mayo low risk criteria for prediction of lymph node involvement.

VI. Compare performance of molecular panel to the high intermediate risk criteria from Gynecologic Oncology Group, trial 99 (GOG 99) for prediction of recurrence.

VII. Determine the feasibility of lymph node mapping in this patient population.

VIII. Determine the morbidity and mortality of lymph node dissection and mapping.

OUTLINE:

Patients undergo hysterectomy and sentinel lymph node mapping. Patients may also undergo bilateral salpingo-oophorectomy at the direction of the treating physician. If peritoneal disease or other contraindications to lymphatic mapping are detected at the time of surgery, mapping and sentinel node biopsy are performed at the surgeon's discretion. At the time of hysterectomy, patients undergo collection of tissue for molecular testing. Before and after surgery, patients also undergo collection of blood samples for tumor marker analysis.

Conditions

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FIGO Grade 1 Endometrial Endometrioid Adenocarcinoma FIGO Grade 2 Endometrial Endometrioid Adenocarcinoma

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Ancillary-Correlative (biospecimen collection, node mapping)

Patients undergo hysterectomy and sentinel lymph node mapping. Patients may also undergo bilateral salpingo-oophorectomy at the direction of the treating physician. If peritoneal disease or other contraindications to lymphatic mapping are detected at the time of surgery, mapping and sentinel node biopsy are performed at the surgeon's discretion. At the time of hysterectomy, patients undergo collection of tissue for molecular testing. Before and after surgery, patients also undergo collection of blood samples for tumor marker analysis.

Bilateral Salpingectomy with Oophorectomy

Intervention Type PROCEDURE

Undergo standard of care bilateral salpingo-oophorectomy

Biospecimen Collection

Intervention Type PROCEDURE

Undergo collection of blood and tissue samples

Hysterectomy

Intervention Type PROCEDURE

Undergo standard of care hysterectomy

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Lymph Node Mapping

Intervention Type PROCEDURE

Undergo sentinel lymph node mapping

Sentinel Lymph Node Biopsy

Intervention Type PROCEDURE

Undergo sentinel lymph node biopsy

Interventions

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Bilateral Salpingectomy with Oophorectomy

Undergo standard of care bilateral salpingo-oophorectomy

Intervention Type PROCEDURE

Biospecimen Collection

Undergo collection of blood and tissue samples

Intervention Type PROCEDURE

Hysterectomy

Undergo standard of care hysterectomy

Intervention Type PROCEDURE

Laboratory Biomarker Analysis

Correlative studies

Intervention Type OTHER

Lymph Node Mapping

Undergo sentinel lymph node mapping

Intervention Type PROCEDURE

Sentinel Lymph Node Biopsy

Undergo sentinel lymph node biopsy

Intervention Type PROCEDURE

Other Intervention Names

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bilateral salpingo-oophorectomy Hysterectomy NOS lymphatic mapping Sentinel Node Biopsy Sentinel node biopsy alone SLNB SNB

Eligibility Criteria

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Inclusion Criteria

* Histologically confirmed low grade (grade 1-2) endometrioid type adenocarcinoma
* Candidate for surgery
* No evidence of deep invasion or peritoneal disease in patients that have undergone preoperative imaging
* Patients may have had prior hormonal treatment for the treatment of early endometrial neoplasia. Patients may not have had prior radiation or chemotherapy for treatment of endometrial cancer
* Patients must have a negative pregnancy if of childbearing potential

Exclusion Criteria

* Histologically confirmed high grade endometrioid or non-endometrioid type endometrial cancer (including serous, clear cell, carcinosarcoma or any mixed tumor containing these cell types)
* Medical co-morbidities making surgery unsafe, as determined by the primary treating physician
* Evidence of deep myometrial invasion, cervical involvement or peritoneal disease on preoperative imaging
* Prior treatment with radiation or chemotherapy for endometrial cancer
* Any contraindication to lymph node mapping
Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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M.D. Anderson Cancer Center

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Shannon N Westin

Role: PRINCIPAL_INVESTIGATOR

M.D. Anderson Cancer Center

Locations

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M D Anderson Cancer Center

Houston, Texas, United States

Site Status

Countries

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United States

Related Links

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http://www.mdanderson.org

MD Anderson Cancer Center Website

Other Identifiers

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NCI-2020-07548

Identifier Type: REGISTRY

Identifier Source: secondary_id

PA12-0550

Identifier Type: OTHER

Identifier Source: secondary_id

PA12-0550

Identifier Type: -

Identifier Source: org_study_id

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