Comparison of Elective Lymph Node Treatment Versus Clinical Observation in the Absence of Palpable Lymph Nodes for High Risk Skin Squamous Cell Carcinoma (SCC)
This study will evaluate if there is a difference in survival between elective treatment of draining lymph nodes vs. clinical nodal observation in patients undergoing Mohs surgery for high risk skin squamous cell carcinoma of the head and neck who have a normal lymph node exam. Each treatment arm is accepted as a current standard of care, and the objective is to compare outcomes between the two arms.
High Risk Cutaneous Squamous Cell Carcinoma
Procedure: elective lymph node dissection
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||High Risk Cutaneous Squamous Cell Carcinoma Treated With Mohs Surgery Randomized to Elective Management of the Draining Lymph Nodes vs. Periodic Clinical Nodal Observation|
- Disease-specific survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Overall survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Disease-free survival [ Time Frame: 5 years ] [ Designated as safety issue: No ]
- Complications [ Time Frame: 5 years ] [ Designated as safety issue: No ]This refers to any adverse event or side effect related to any of the study interventions.
- quality of life [ Time Frame: 5 years ] [ Designated as safety issue: No ]This refers to quality of life measured with a standard questionnaire. The two arms will be compared with respect to their differences (if any) in quality of life.
|Study Start Date:||April 2011|
|Estimated Study Completion Date:||May 2022|
|Estimated Primary Completion Date:||May 2017 (Final data collection date for primary outcome measure)|
Active Comparator: Elective lymph node treatment arm
Patients entering this arm will undergo selective nodal dissection of the draining lymph nodes with subsequent radiation and/or chemotherapy if indicated.
Procedure: elective lymph node dissection
This entails selective lymph node dissection in patients with negative lymph node exams. The nodes dissected are those that drain from the high risk cutaneous squamous cell cancer. Subsequent radiation and/or chemotherapy may be administered in a small percentage of subjects, depending on the result of the neck dissection.
No Intervention: Clinical observation arm
Patients who enter into this arm will undergo regular, periodic clinical nodal observation with subsequent evaluation and treatment if indicated upon discovery of a palpable lymph node.
This is a prospective, randomized, non-blinded, controlled trial of high risk head and neck cutaneous squamous cell carcinomas which will compare specific outcomes between two treatment arms. Subjects are eligible patients who are sent to Zitelli & Brodland PC for Mohs micrographic surgery of tumors that meet our high risk criteria. These patients with clinically-negative lymph node exams will either enter into the arm of nodal observation or the arm of elective management of the neck, which is currently the standard protocol per the UPMC ENT department. The patients in the observation arm will have evaluation and treatment of their lymph nodes if an abnormality is detected clinically. The primary endpoint is disease-specific survival. Secondary endpoints will include overall and disease-free survival, complications, and quality of life measures for each arm.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01252329
|United States, Pennsylvania|
|UPMC Department of Otolaryngology|
|Pittsburgh, Pennsylvania, United States, 15213|
|Zitelli & Brodland PC|
|Pittsburgh, Pennsylvania, United States, 15232|
|Principal Investigator:||John A Zitelli, MD||Zitelli & Brodland PC; UPMC Departments of Dermatology and Otolaryngology|
|Principal Investigator:||David G Brodland, MD||Zitelli & Brodland PC; UPMC Departments of Dermatology and Otolaryngology|
|Principal Investigator:||Uma Duvvuri, MD,PhD||UPMC Department of Otolaryngology|
|Principal Investigator:||Christine H Weinberger, MD||Zitelli & Brodland PC|