Interest of a Systematic Biopsy for Hard-to-heal Leg Ulcers (ULCERE)
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Purpose
Primary aim of the study : to evaluate the prevalence of ulcerated cutaneous carcinoma or malignant degeneration, in leg ulcers, presumed of vascular origin and without evidence of healing despite 3 months of adequate treatmentSecondary aims of the study : to evaluate the interest of immunostainings for desmogleins 1-2 and p16 on biopsies to differentiate between pseudo epitheliomatous hyperplasia and squamous cell carcinoma ; and the prognosis of diagnosed carcinomas at 12 monthsStudy hypothesis : systematic biopsies of hard-to-heal leg ulcer may help to detect ulcerated carcinomas misdiagnosed as vascular ulcer or malignant degeneration of leg ulcer.
| Condition |
|---|
|
Chronic Leg Ulcers |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Prospective Evaluation of the Interest of a Systematic Biopsy for Hard-to-heal Leg Ulcers |
| Enrollment: | 155 |
| Study Start Date: | December 2006 |
| Study Completion Date: | May 2010 |
| Primary Completion Date: | June 2009 (Final data collection date for primary outcome measure) |
Prospective multicentric inclusion of 150 patients with leg ulcers without any evidence of healing (no change or increase of ulcer area) despite 3 months of adequate treatment The study population consisted of consecutive patients with one or more leg ulcers, diagnosed as related to venous insufficiency, associated or not with concomitant arterial insufficiency. All patients undergo a standard treatment including compression therapy adapted to the ankle brachial index and a local treatment depending on the wound stage.At inclusion, systematic punch biopsies (5-6 mm) are taken as part of routine clinical care under local anaesthetic by an experienced clinician: 1 to 2 biopsies in the edges and 1 to 2 biopsies in the wound bedSpecimens are transported in formalin solution to the usual pathology laboratory of the investigator. At the end of the study, specimens will be sent for immunostainings in a single pathology laboratory (Rouen, France)Treatments and/or other investigations are decided by the investigatorAt 12 months of usual follow-up, final diagnosis and prognosis are noted in the study file by the investigator.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Patients with one or more leg ulcers, diagnosed as related to venous insufficiency, associated or not with concomitant arterial insufficiency.
Inclusion Criteria:
- leg ulcer of more than 3 months of duration
- leg ulcer presumed of vascular origin
- adequate etiologic treatment since 3 months
- absence of evidence of healing : absence of reduction of wound area or increase in wound area and/or in depth
Exclusion Criteria:
- hypertensive ulcer
- vasculitis
- treatment by cytotoxic agents or steroids in the previous 3 months
Contacts and Locations| France | |
| Patricia SENET, MD | |
| Ivry sur Seine, Ile de France, France, 94205 | |
| Principal Investigator: | Patricia SENET, MD | AP-HP, Hôpital Charles Foix, 94205 Ivry/Seine, France et Hôpital Tenon, 75020 Paris, France |
More Information
No publications provided by Assistance Publique - Hôpitaux de Paris
Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Assistance Publique - Hôpitaux de Paris |
| ClinicalTrials.gov Identifier: | NCT00709631 History of Changes |
| Other Study ID Numbers: | 00006477 |
| Study First Received: | July 2, 2008 |
| Last Updated: | September 15, 2012 |
| Health Authority: | France: Ministry of Health |
Keywords provided by Assistance Publique - Hôpitaux de Paris:
|
Malignant transformation of leg ulcer MARJOLIN's ulcer Biopsy Leg ulcer |
Chronic wound Squamous cell carcinoma Basal cell carcinoma |
Additional relevant MeSH terms:
|
Leg Ulcer Ulcer Skin Ulcer Skin Diseases Pathologic Processes |
ClinicalTrials.gov processed this record on May 16, 2013