Cervical Cancer Clinical Trial
Official title:
Study on Selective Pelvic Lymphadenectomy for IB-IIA Cervical Cancer
Test name:
Study on selective pelvic lymphadenectomy for IB - IIA cervical cancer Researcher: Wu Xiaohua
Research Center: Fudan University Shanghai Cancer Center The trial is expected to last for 3
years Test objectives: The primary goal:The overall therapeutic effect of patients with
selective lymphadenectomy was not inferior to patients with systemic pelvic lymphadenectomy.
Secondary goal: Selective lymphadenectomy can reduce the incidence and severity of
postoperative lower limb lymphedema.
The study was designed for prospective, randomized, controlled clinical trials. The number of
subjects: 200 cases. Research groupings Selective pelvic lymphadenectomy group and The
control group was treated with systematic pelvic lymph node dissection group.
Follow-up time: 3 years Sample size: 200 cases
End of the trial:
Primary end-poin:t three-year survival (overall survival, progression-free survival)
Secondary end point: lower limb lymph node lymphedema
Overall objective For cervical cancer patients with confirmed lymph node metastasis by
intraoperative frozen pathology, the overall treatment effect of radical hysterectomy and
selective enlarged lymph node dissection is not inferior to systematic pelvic lymphadenectomy
and can reduce postoperative lower limb lymphedema incidence and severity.
1. The purpose of this study
1. to assess whether the progression free survival of patients with selective enlarged
pelvic lymph node resection is better than patients with systematic pelvic lymph node
dissection.
2. to evaluate differences of the incidence and severity of lymphedema between the two
group patients using Lymphedema Staging standards (Stage 0-3) according to the"consensus
document"of the International Society of Lymphology.
2. Preoperative evaluation LEEP, conization or biopsy Vagino-recto-abdominal examination +
Vaginal / vaginal colposcopy examination History of Medical, surgical and childbearing
Complications Physical condition Height and weight History of smoking Pregnancy test Chest
X-ray or chest CT or general PET/CT Abdominal CT or general PET/CT Pelvic MRI/CT or general
PET/CT
3.Protocol Patients with stage IB-IIa cervical cancer were randomly divided into two
groups(Control group and Experimental group).Frozen pathological examination will be
performed during the operation, and patients with positive lymph node metastasis will undergo
radical hysterectomy and systematic pelvic lymphadenectomy or radical hysterectomy and
selective enlarged lymph node dissection according to the patient's group.
4. Postoperative adjuvant therapy All patients with pelvic lymph node metastasis are required
to receive DDP based concurrent chemoradiotherapy.
5.Efficacy evaluation Overall survival (OS): The period from randomization to death for any
cause (for patients who have been loss to follow-up prior to death, the last follow-up time
is calculated as the time of death).
Progression free survival (PFS): The duration from randomization to the earliest date of the
date of tumor progression or the date of death for any cause. If the above standards are not
met, the final evaluation date should be used for analysis.
Assessment of lymphedema in lower extremities: Lymphedema Staging standards (Stage 0-3)
according to the"consensus document"of the International Society of Lymphology were used :
Stage 0 Subclinical with possible clinical evolution Stage I Edema regressing with treatments
with positive pitting test Stage II Edema partially regressing with treatments with negative
pitting test Stage III Elephantiasis with cutaneous complications and recurrent infections.
6. Follow up The patients were followed up every 3 months for the first year, every 4 months
for the second year and every 6 months from the third year.
In addition to routine oncologic follow-up, the stage of patients̛ lower extremity lymphedema
should also be evaluated.
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