Hysteroscopic Injection of Tracers for Sentinel Node Identification in Women With Endometrial Cancer
Lymph nodes are oval-shaped glands where immune reactions occur. For patients with
endometrial cancer, lymph node status is an important factor for planning the cancer
treatment course and predicting the status of the cancer. The "sentinel" node is the lymph
node closest to the main tumor area, and it is believed to be at greatest risk for spread of
the cancer. If the sentinel node does not contain cancer cells, then the remaining lymph
nodes are usually cancer-free.
In this study, researchers want to study possibly using lymphatic mapping in future patients
as an alternative to completely removing the lymph nodes in the pelvis (hip area) and
para-aortic (upper abdomen) area.
Intraoperative sentinel lymph node identification (lymphatic mapping) uses 2 techniques.
The first technique involves injecting a small amount of weak radioactive material, and the
second involves injecting a drug called isosulfan blue or methylene blue. These techniques
are being studied to see if the surgeon can locate ("map") lymph nodes that may contain
Routine Surgical Treatment:
As part of routine care, all participants in this study will have surgery to remove the
uterus, cervix, 1-2 inches of the vagina, fallopian tubes, ovaries, and the lymph nodes in 2
areas of the waist.
If you agree to take part in this study, after you have been given the anesthetic for your
surgery, your uterus will be examined to locate the tumor(s). After the tumor(s) are
located, they will be injected with a radioactive substance called Tc-99m sulfur colloid.
The tumors will then be injected with a dye called isosulfan blue or methylene blue, which
is used to turn the sentinel node blue.
Before and during your surgery, a gamma counter (a special hand-held instrument that
measures radioactivity) will be used to identify lymph nodes that have absorbed the Tc-99m
sulfur colloid. The surgeon will also be able to see the lymph nodes that have absorbed the
In addition to the study procedures, researchers will collect clinical information about you
that will be compared with the study results. This information includes your date of birth,
age, race, height, weight, number of any past pregnancies and deliveries, any other medical
conditions, and any earlier surgeries. It also includes the date of the cancer diagnosis,
the status of the cancer diagnosis before surgery, the status of the disease, and the
results of routine scans before surgery (chest x-ray and computed tomography [CT] or
magnetic resonance imaging [MRI] scan, if performed).
Length of Study Participation:
Your participation in this study will be over after the 15-20 minute procedure for
identifying the sentinel nodes. The routine surgery will occur after that, which can take
up to 5 hours.
This is an investigational study. Tc-99m sulfur colloid, the blue dye (either isosulfan
blue or methylene blue), and the gamma counter are FDA approved for the procedures used in
Performing lymph node mapping and sentinel node identification during surgery in patients
with endometrial cancer is considered experimental.
Up to 20 women will take part in this multicenter study. Up to 10 will be enrolled at M. D.
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Diagnostic
Sentinel Node Identification Rate
Feasibility of sentinel node identification rate using intraoperative hysteroscopic injection of patent blue dye and radiocolloid for the detection of sentinel lymph nodes in patients with endometrial cancer. Sentinel node identification before and during surgery using a gamma counter to identify lymph nodes that have absorbed Tc-99m sulfur colloid. Study feasibility assessed with enrollment of 20 participants, approximately 1 year.
15-20 minute procedure prior to/during routine surgery for identifying the sentinel nodes
Michael M. Frumovitz, MD
M.D. Anderson Cancer Center
United States: Institutional Review Board
|UT MD Anderson Cancer Center||Houston, Texas 77030|
|St. Luke's Episcopal Hospital||Houston, Texas 77030|