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Cervix CancerNCT06196190

Prognostic Value of Conization and Negative HPV After Conization in AIS and Early Stage Cervical Cancer

An observational study of Cervix Cancer and HPV-Related Malignancy, run by Rambam Health Care Campus at 1 site in Israel.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

In women with cervical cancer -Squamous cell carcinoma, Adeno carcinoma, Adeno-squamous carcinoma or AIS we want to examine prospectively: 1. Examine if negative HR-HPV after conization to the HR-HPV the women had before conization has a high prognostic value for no residual tumor in the final pathology. 2. Read more about this study

Who is it for?
Ages 18 to 85 years, women only
Conditions the study is for
Cervix Cancer, HPV-Related Malignancy
How many people
200 participants
Where
1 siteIsrael
Study dates
26 Jul 2023to 1 Jul 2028
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 85 years
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Study population: Women with cervical cancer -Squamous cell carcinoma, Adeno carcinoma, Adeno-squamous carcinoma or AIS

Who may be able to join

  • Age Range: 18-85 years old Cervical cancer stage I B 2(Tumor up to 4 cm FIGO 2018) AIS HPV types before and after conization

Who cannot join

  • Pregnant women under 18 years old. Women who refused to continue to be in study. Women that data about HPV types , final pathology or complication are missing.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Yoav Siegler, MD contact

+972528263054

yoav.siegler@gmail.com

Israel1 site, 1 recruiting
  • Rambam Health Care Center

    Haifa, 31906

    Yoav Siegler, MD, yoav.siegler@gmail.com

    Recruiting

Other trials in Israel

About this study

Official title: The Prognostic Value of Conization and Negative HPV Typing After Conization Prior to Surgical Intervention in Adenocarcinoma in Situ and Early Stage Cervical Cancer

In women with cervical cancer -Squamous cell carcinoma, Adeno carcinoma,

Adeno-squamous carcinoma or AIS we want to examine prospectively:

  1. Examine if negative HR-HPV after conization to the HR-HPV the women had before conization has a high prognostic value for no residual tumor in the final pathology.
  2. To examine if conization in women with cervical tumor up to Stage I B 2 (FIGO 2018) is corelated with better prognosis.
Read the detailed description

The treatment of invasive cervical cancer is tailored according to the FIGO recommendations. The standard treatment for women with early-stage, (IA2-IB1) cervical cancer is simple or Radical Hysterectomy (RH) and in women with Adenocarcinoma in Situ hysterectomy is recommended when they finish their fertility program .A Few studies describe that conization before Radical Hysterectomy in women with cervical cancer stage I B 1 ( tumour up to 4 cm according to FIGO 2009 ) , are in correlation with better prognosis , Bizzari describe women that had conization before RH had better 5 year survival. Uppal report that those women have less recurrence, OR of 0.4 compared with women without conization. Chacon summarize SUCCOR study, a multi center study that collected data about 374 women with cervical cancer Stage I B 1 according to FIGO 2009 -tumour up to 4 cm .187 women had conization before RH and 187 had RH without conization. Women that had conization had 65% less recurrence 'and 75% les mortality.

Several studies have explored the possibility of a less aggressive approach for cervical cancer patients with low-risk early-stage disease who wish to preserve fertility. The parameters that were investigated were: the depth of invasion, tumour diameter, lymph node status positive margins in conization, positive Endo Cervical Curettage (ECC) and lymph-vascular space invasion. Those parameters have a low sensitivity and between 50-65% of women who had RH had no residual tumour in the final pathology.

Schmeler describe that woman who had conization before RH in 97.5% had no residual tumour.

A study of 92 women with cervical cancer and Adeno Carcinoma In situ (AIS) that short time after conization were negative to High-Risk HPV (HR-HPV) they had before the conization in 95% there was no residual tumour in the final pathology, or during the follow up.

To our knowledge there is no prospective study that examined the the prognostic value of Conization and negative HR- HPV typing after Conization prior to surgical intervention in Early-Stage Cervical Cancer and Adenocarcinoma in Situ.

Aim:

In women with cervical cancer -Squamous cell carcinoma, Adeno carcinoma,

Adeno-squamous carcinoma or AIS we want to examine prospectively:

  1. Examine if negative HR-HPV after conization to the HR-HPV the women had before conization has a high prognostic value for no residual tumour in the final pathology.
  2. To examine if conization in women with cervical tumour up to Stage I B 2 (FIGO 2018) is corelated with better prognosis.
Medical subject headings
Uterine Cervical Neoplasms

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT06196190
Study groupRoleWhat they receive
Post Conization HR HPV positiveWomen with a Post Conization cervical test positive for HR HPV
Post Conization HR HPV negativeWomen with a Post Conization cervical test negative for HR HPV
No Conization HR HPV positiveWomen who did not go through Conization prior to surgery and had a cervical test positive for HR HPV
No Conization HR HPV negativeWomen who did not go through Conization prior to surgery and had a cervical test negative for HR HPV

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Final Pathology

    Residual disease in final pathology

    Measured: 1 year

Secondary outcomes (3)
  1. Disease recurrence

    number of months until Disease recurrence

    Measured: 5 year

  2. Mortality

    mortality rate during the study between the groups

    Measured: 5 year

  3. complications

    major complications

    Measured: 5 year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 Jan 2024
  2. Study start26 Jul 2023
  3. Primary completion1 Aug 2026 (estimated)
  4. Study completion1 Jul 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Prospective
Enrolment
200 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06196190
Sponsor's protocol ID
0256-23-RMB
Status last verified
Jan 2024
First submitted
30 Sep 2023
Last updated
9 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • de Sanjose S, Quint WG, Alemany L, Geraets DT, Klaustermeier JE, Lloveras B, Tous S, Felix A, Bravo LE, Shin HR, Vallejos CS, de Ruiz PA, Lima MA, Guimera N, Clavero O, Alejo M, Llombart-Bosch A, Cheng-Yang C, Tatti SA, Kasamatsu E, Iljazovic E, Odida M, Prado R, Seoud M, Grce M, Usubutun A, Jain A, Suarez GA, Lombardi LE, Banjo A, Menendez C, Domingo EJ, Velasco J, Nessa A, Chichareon SC, Qiao YL, Lerma E, Garland SM, Sasagawa T, Ferrera A, Hammouda D, Mariani L, Pelayo A, Steiner I, Oliva E, Meijer CJ, Al-Jassar WF, Cruz E, Wright TC, Puras A, Llave CL, Tzardi M, Agorastos T, Garcia-Barriola V, Clavel C, Ordi J, Andujar M, Castellsague X, Sanchez GI, Nowakowski AM, Bornstein J, Munoz N, Bosch FX; Retrospective International Survey and HPV Time Trends Study Group. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol. 2010 Nov;11(11):1048-56. doi: 10.1016/S1470-2045(10)70230-8. Epub 2010 Oct 15.

    PubMed 20952254
  • Siegler E, Reichman Y, Kugelman N, Mackuli L, Lavie O, Ostrovsky L, Shaked-Mishan P, Segev Y. Low-Risk Human Papillomavirus Types in Cervical Intraepithelial Neoplasia 2-3 and in Invasive Cervical Cancer Patients. J Low Genit Tract Dis. 2019 Oct;23(4):248-252. doi: 10.1097/LGT.0000000000000486.

    PubMed 31592971
  • Cuschieri K, Bhatia R, Cruickshank M, Hillemanns P, Arbyn M. HPV testing in the context of post-treatment follow up (test of cure). J Clin Virol. 2016 Mar;76 Suppl 1:S56-S61. doi: 10.1016/j.jcv.2015.10.008. Epub 2015 Oct 22.

    PubMed 26525202
  • Bizzarri N, Pedone Anchora L, Kucukmetin A, Ratnavelu N, Korompelis P, Carbone V, Fedele C, Bruno M, Vizzielli G, Gallotta V, De Vincenzo R, Chiantera V, Fagotti A, Fanfani F, Ferrandina G, Scambia G. Protective Role of Conization Before Radical Hysterectomy in Early-Stage Cervical Cancer: A Propensity-Score Matching Study. Ann Surg Oncol. 2021 Jul;28(7):3585-3594. doi: 10.1245/s10434-021-09695-4. Epub 2021 Feb 23.

    PubMed 33620615
  • Uppal S, Gehrig PA, Peng K, Bixel KL, Matsuo K, Vetter MH, Davidson BA, Cisa MP, Lees BF, Brunette LL, Tucker K, Stuart Staley A, Gotlieb WH, Holloway RW, Essel KG, Holman LL, Goldfeld E, Olawaiye A, Rose SL. Recurrence Rates in Patients With Cervical Cancer Treated With Abdominal Versus Minimally Invasive Radical Hysterectomy: A Multi-Institutional Retrospective Review Study. J Clin Oncol. 2020 Apr 1;38(10):1030-1040. doi: 10.1200/JCO.19.03012. Epub 2020 Feb 7.

    PubMed 32031867
  • Chacon E, Manzour N, Zanagnolo V, Querleu D, Nunez-Cordoba JM, Martin-Calvo N, Capilna ME, Fagotti A, Kucukmetin A, Mom C, Chakalova G, Shamistan A, Gil Moreno A, Malzoni M, Narducci F, Arencibia O, Raspagliesi F, Toptas T, Cibula D, Kaidarova D, Meydanli MM, Tavares M, Golub D, Perrone AM, Poka R, Tsolakidis D, Vujic G, Jedryka MA, Zusterzeel PLM, Beltman JJ, Goffin F, Haidopoulos D, Haller H, Jach R, Yezhova I, Berlev I, Bernardino M, Bharathan R, Lanner M, Maenpaa MM, Sukhin V, Feron JG, Fruscio R, Kukk K, Ponce J, Minguez JA, Vazquez-Vicente D, Castellanos T, Boria F, Alcazar JL, Chiva L; SUCCOR study group; SUCCOR study Group. SUCCOR cone study: conization before radical hysterectomy. Int J Gynecol Cancer. 2022 Feb;32(2):117-124. doi: 10.1136/ijgc-2021-002544. Epub 2022 Jan 17.

    PubMed 35039455
  • Plante M, Renaud MC, Francois H, Roy M. Vaginal radical trachelectomy: an oncologically safe fertility-preserving surgery. An updated series of 72 cases and review of the literature. Gynecol Oncol. 2004 Sep;94(3):614-23. doi: 10.1016/j.ygyno.2004.05.032.

    PubMed 15350349
  • Suri A, Frumovitz M, Milam MR, dos Reis R, Ramirez PT. Preoperative pathologic findings associated with residual disease at radical hysterectomy in women with stage IA2 cervical cancer. Gynecol Oncol. 2009 Jan;112(1):110-3. doi: 10.1016/j.ygyno.2008.09.011. Epub 2008 Oct 25.

    PubMed 18952270
  • Li X, Xia L, Chen X, Fu Y, Wu X. Simple conization and pelvic lymphadenectomy in early-stage cervical cancer: A retrospective analysis and review of the literature. Gynecol Oncol. 2020 Aug;158(2):231-235. doi: 10.1016/j.ygyno.2020.05.035. Epub 2020 Jun 6.

    PubMed 32518013
  • Costa S, Negri G, Sideri M, Santini D, Martinelli G, Venturoli S, Pelusi C, Syrjanen S, Syrjanen K, Pelusi G. Human papillomavirus (HPV) test and PAP smear as predictors of outcome in conservatively treated adenocarcinoma in situ (AIS) of the uterine cervix. Gynecol Oncol. 2007 Jul;106(1):170-6. doi: 10.1016/j.ygyno.2007.03.016. Epub 2007 May 4.

    PubMed 17481701
  • Costa S, Sideri M, Negri G, Venturoli S, Santini D, Casadio C, Sandri MT, Bucchi L. The predictive value of human papillomavirus testing for the outcome of patients conservatively treated for stage IA squamous cell cervical carcinoma. J Clin Virol. 2015 Sep;70:53-57. doi: 10.1016/j.jcv.2015.07.007. Epub 2015 Jul 8.

    PubMed 26305820
  • Siegler E, Goldberg Y, Siegler Y, Shaked-Mishan P, Mazareb S, Kugelman N, Mackuli L, Sabo E, Lavie O, Segev Y. The Association Between Clearance of Human Papillomavirus After Conization for Cervical Cancer and Absence of Cancer. J Low Genit Tract Dis. 2021 Oct 1;25(4):276-280. doi: 10.1097/LGT.0000000000000622.

    PubMed 34369434

Questions about this trial

What is this clinical trial studying?

An observational study of Cervix Cancer and HPV-Related Malignancy, run by Rambam Health Care Campus at 1 site in Israel.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 9 Jan 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Israel. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Yoav Siegler, MD (+972528263054, yoav.siegler@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Final Pathology (time frame: 1 year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06196190, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jan 2024.

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