Intraoperative Pathological Evaluation for Surgical Treatment & Staging for Endometrial Cancer
| Status: | Active, not recruiting |
|---|---|
| Conditions: | Cervical Cancer, Cancer, Endometrial Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 10/31/2018 |
| Start Date: | January 2012 |
| End Date: | July 28, 2021 |
Treatment of Endometrial Cancer Utilizing Pathology Intraoperative Consultation to Determine Extent of Surgical Staging
Complete pelvic and para-aortic lymphadenectomy performed at the time of primary surgical
staging for endometrial cancer increases operative time and surgical morbidity, but appears
to be necessary in most high grade and deeply invasive cancers. To date, the Mayo Clinic
approach has not been reproduced, and the investigators propose to validate their algorithm
at the University of Kentucky utilizing intra-operative consultation (IOC). The preliminary
data at the University of Kentucky for IOC and endometrial cancer outcomes suggest that the
investigators are well-suited to perform this investigation. A surgical approach that is
tailored to the patient's cancer biology is rational, supported by the recent literature, and
medically compelling since the co-morbidities of many obese, low-risk EC patients put them at
significantly increased perioperative risk for complete lymphadenectomy.
staging for endometrial cancer increases operative time and surgical morbidity, but appears
to be necessary in most high grade and deeply invasive cancers. To date, the Mayo Clinic
approach has not been reproduced, and the investigators propose to validate their algorithm
at the University of Kentucky utilizing intra-operative consultation (IOC). The preliminary
data at the University of Kentucky for IOC and endometrial cancer outcomes suggest that the
investigators are well-suited to perform this investigation. A surgical approach that is
tailored to the patient's cancer biology is rational, supported by the recent literature, and
medically compelling since the co-morbidities of many obese, low-risk EC patients put them at
significantly increased perioperative risk for complete lymphadenectomy.
Inclusion Criteria:
- All patients must be surgical candidates for complete hysterectomy and bilateral
salpingo-oophorectomy and pelvic and aortic lymphadenectomy.
- Patients must have a histologically confirmed diagnosis of endometrial cancer and no
clinical evidence of extra-uterine disease on preoperative evaluation.
- Preoperative evaluation to rule-out extra-uterine disease may include CT scan, MRI, or
ultrasound. Preoperative imaging is not mandatory for study enrollment.
- Patients may have received prior systemic chemotherapy. Such therapy must have been
completed at least 5 years prior to study entry and the patient has no evidence of
disease subsequent to such therapy. Patients must not have received neoadjuvant
chemotherapy for the present disease.
- Patients must have GOG performance status 0, 1, or 2.
- Patients must have an estimated survival greater than or equal to 3 months
- Patients who have met the pre-entry requirements specified in Section 7.0.
- Patients must have signed an approved informed consent and HIPAA authorization.
Exclusion Criteria:
- Patients with clinical evidence of disease beyond the uterus, including presence of
suspicious aortic or inguinal nodes on imaging or clinical exam.
- Patients who have received previous vaginal, pelvic, or abdominal irradiation.
- Patients who received chemotherapy directed at the present disease.
- Patients who have circumstances that will not permit completion of this study or the
required follow-up.
- Patients with renal abnormalities, such as pelvic kidney, horseshoe kidney, or renal
transplantation, that would require modification of surgical lymph node assessments.
- Patients with a history of other invasive malignancies, with the exception of
non-melanoma skin cancer within the last five years.
- Patients with GOG Performance Grade of 3 or 4.
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