PET/MR for Staging Rectal Cancer Patients With and Without EMVI-MR
|ClinicalTrials.gov Identifier: NCT02537340|
Recruitment Status : Completed
First Posted : September 1, 2015
Last Update Posted : June 22, 2020
|Condition or disease|
The accurate staging of rectal cancer is essential to define therapy and for prognosis assessment. Imaging modalities usually provide useful information for pre-operative planning of primary tumour resection and may indicate the need of neoadjuvant treatment. It is recommended the use of magnetic resonance imaging (MRI) for local staging and computed tomography (CT) of chest, abdomen and pelvis for detection of distant metastasis. Patients with rectal cancer and vascular invasion might benefit from an intensive pre-operative staging in order to early detect distant metastasis, favouring a better therapeutic planning. There is no consensus regarding the use of PET/MR for initial staging of patients with rectal cancer. It has been shown that although changing pattern's in patients' stage, the use of PET/MR for colorectal cancers did not impact disease management. New studies are required for identifying the subgroup of patients with changes in the pre-operative MR that might benefit from the use of PET/MR for initial staging of rectal cancers.
Patients with rectal cancer will undergo pelvic MR, whole-body CT and whole-body PET/MR. According to the tumour characteristics on MR, there will be defined two group of patients: with EMVI-RM (group A) and without EMVI-MR (group B). The whole-body CT and PET/MR will be evaluated for the detection of loco-regional lymph nodes disease and distant metastasis. The total number of lesions and their respective sites will be recorded and compared for each method. The PET/MR management impact will be determined from the medical record or by direct contact with the treating clinician. The impact of PET/MR on management will be defined as high (the treatment modality or intent was changed), medium (the treatment modality or intent remained unchanged, although the method of treatment delivery or planned diagnostic procedure was changed), low (PET/MR results were consistent with planned management, and treatment modality or intent was unchanged), or none (the management plan was not changed, despite being inconsistent with the PET/MR stage—that is, PET/MR results were ignored). Overall survival will be used to evaluate prognostic significance. Clinical follow-up will be performed 3 monthly for 2 years. Imaging and, eventually biopsy, will be performed to evaluate symptoms or signs suggestive of residual or recurrent disease.
|Study Type :||Observational|
|Actual Enrollment :||104 participants|
|Official Title:||The Use of PET/MR for Initial Staging of Rectal Cancer Patients With Extramural Vascular Invasion Detected by MR (EMVI-MR)|
|Actual Study Start Date :||September 2016|
|Actual Primary Completion Date :||April 2018|
|Actual Study Completion Date :||May 2019|
Patients with primary rectal cancer and extramural vascular invasion detected by staging MR
Patients with primary rectal cancer and without extramural vascular invasion detected by staging MR
- Detection rate [ Time Frame: 12 months ]Number of metastatic lesions detected
- Clinical Impact [ Time Frame: 12 months ]Measured by change in patient's therapy through questionnaire applied to referring physician
- Progression-free survival [ Time Frame: 36 months ]Measured in terms of loco-regional or distant recurrence by 3 years.
- Overall survival [ Time Frame: 36 months ]Measured in terms of death related to disease by 3 years.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02537340
|Instituto do Câncer do Estado de São Paulo|
|São Paulo, Brazil, 01255000|
|Study Director:||Carlos Buchpiguel, MD, PhD||University of São Paulo|