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Trial registered on ANZCTR
Registration number
ACTRN12611000713998
Ethics application status
Approved
Date submitted
7/06/2011
Date registered
11/07/2011
Date last updated
11/07/2011
Type of registration
Prospectively registered
Titles & IDs
Public title
A Prospective randomised trial of sentinel node biopsy for high risk non-melanoma skin cancer.
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Scientific title
A phase III Multicenter Randomised Trial in High Risk Non Melanoma Skin Cancer of Sentinel Lymph Node Biopsy and Lymphadenectomy versus Nodal Observation on Disease Free and Overall Survival.
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Secondary ID [1]
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Nil
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Universal Trial Number (UTN)
U1111-1118-3627
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Trial acronym
SNIC trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Non melanoma skin cancer
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Condition category
Condition code
Cancer
266004
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0
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Non melanoma skin cancer
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Wide local excision of the primary site and Sentinel lymph node biopsy (SLNB) with completion lymphadenectomy (second procedure at later date) for histopathologically positive sentinel nodes.
Both sentinel node positive and sentinel node negative patients will receive 5 years follow up and continuing observation of lymphatic basin for metastasis.
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Intervention code [1]
264576
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Treatment: Surgery
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Intervention code [2]
266937
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Early detection / Screening
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Intervention code [3]
266938
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Diagnosis / Prognosis
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Comparator / control treatment
Wide local excision of primary and observation of regional lymph nodes 5 years follow up.
Patients that develop clinically apparent nodal metastases during observation will then receive completion lymphadenectomy.
All trial patients will be reviewed every 4 months for the first 2 years, and then every 6 months for the remaining 3 years. Nodal ultrasound +/- fine needle aspiration biopsy will be performed if clinical suspicion of nodal metastasis at any stage in both groups.
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Control group
Active
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Outcomes
Primary outcome [1]
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Disease free survival.
Disease-free survival is the time from the patient's randomisation to treatment group until the date of diagnosis of recurrent disease in the local regional lymph nodes, or distant metastases.
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Assessment method [1]
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Timepoint [1]
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All subjects all followed until death, or at least 5 years. Follow up intervals are every 4 months for the first 2 years, the every 6 months for the remaining 3 years.
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Primary outcome [2]
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Overall survival.
Overall survival is the time from the patient's randomisation of treatment to the date of death from any cause.
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Assessment method [2]
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Timepoint [2]
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All subjects all followed until death, or at least 5 years. Follow up intervals are every 4 months for the first 2 years, the every 6 months for the remaining 3 years.
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Secondary outcome [1]
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Disease-specific survival.
This is the time from the patient's randomisation until the date of the patients death due to non melanoma skin cancer.
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Assessment method [1]
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Timepoint [1]
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All subjects all followed until death, or at least 5 years. Follow up intervals are every 4 months for the first 2 years, the every 6 months for the remaining 3 years.
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Secondary outcome [2]
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Quality of life in both patient groups will be assessed using the QOL tools EORTC QLQ-H&N35 and EORTC QLQ-C30.
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Assessment method [2]
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Timepoint [2]
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Patients in both groups will be asked to complete quality of life questionnaires prior to randomisation, and at the 4 months and yearly after their surgery until 5 years reached.
Mean individual changes in quality of life will be compared between treatment arms.
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Eligibility
Key inclusion criteria
Participants must be able to give fully informed consent and have non melanoma skin cancer with any of the following clinicopathologic risk factors:
-size > 2cm
-invasion into subcutaneous fat or tumour thickness > 5mm
-poorly differentiated phenotype
-perineural invasion
-lymphovascular invasion
-local recurrence
-location of lesion on lip or ear
-immunocomprimised host (post organ transplant, chemotherapy)
-carcinoma developing in pre-existing scar
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Subjects meeting any of the following criteria will be excluded from participation:
-Clinical evidence of distant metastases
-previous surgery that is believed to have altered the local lymphatic drainage since emergence of lesion
-allergy to patent blue dye or radiocolloid
-significant cognitive or psychiatric disorder (inability to understand informed consent)
-pregnancy/lactation
-inability to complete 5 years of follow up
-Participation in concurrent experimental protocols or alternative therapies that might confound the analysis of this trial. Adjuvant therapy protocols after recurrence are acceptable.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
random permuted variable size block design
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
nil
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/01/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
300
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment outside Australia
Country [1]
3587
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New Zealand
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State/province [1]
3587
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Country [2]
3588
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Canada
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State/province [2]
3588
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Sydney Head and Neck Cancer Institute
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Address [1]
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PO Box 142
Missenden Road
Camperdown
NSW 2050
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Country [1]
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Australia
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Primary sponsor type
Charities/Societies/Foundations
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Name
Sydney Head and Neck Cancer Institute
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Address
PO Box 142
Missenden Road
Camperdown
NSW 2050
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Nil
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Sydney Local Health Network Ethics Review Committee (RPAH zone)
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Ethics committee address [1]
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c/- Research Development Office Royal Prince Alfred Hospital Missenden Road Camperdown NSW 2050
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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11/11/2009
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Approval date [1]
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03/12/2009
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Ethics approval number [1]
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HREC/09RPAH/547
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Summary
Brief summary
This study aims to determine the effect of sentinel lymph node biopsy on survival in people with high risk non melanoma skin cancer. Who is it for? You can join this study if you are aged 18 years or more, have high risk non melanoma skin cancer, and will be available for a 5 year follow-up assessment. Trial details Participants in this trial will be randomly (by chance) allocated to one of two groups. Both groups will undergo removal of their skin cancer. In addition, participants in one group will receive sentinel lymph node biopsy. This is a procedure in which the local lymph node ("gland") that drain the patch of skin containing the tumour are excised. These lymph node(s) are examined under a microscope to determine whether cancer cells are present. If cancer cells are found, patients will undergo completion lymphadenectomy (i.e. surgical removal of the rest of the regional lymph nodes). Participants in the second group will undergo observation of regional lymph nodes, and those that develop cancer cells will undergo completion lymphadenectomy. All patients will undergo continued observation for a period of 5 years to determine survival and quality of life.
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Trial website
http://www.shnci.org/Pages/research03.html
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Sarah Davies
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Address
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Sydney Head and Neck Cancer Institute
PO Box M142
Missenden Road
Camperdown
NSW 2050
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Country
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Australia
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Phone
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61 2 9515 7535
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Fax
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61 2 9515 7483
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Email
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[email protected]
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Contact person for scientific queries
Name
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Jonathan Clark
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Address
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Sydney Head and Neck Cancer Institute
PO Box M142
Missenden Road
Camperdown
NSW 2050
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Country
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Australia
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Phone
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61 2 9553 8827
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Fax
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61 2 9515 7483
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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