The purpose of this study is to evaluate whether injection of carbon nanoparticle as a lymph node tracer before neoadjuvant radiochemotherapy in rectal cancer can increase lymph node yield after surgery compared which do not inject.
This is the randomized controlled, multi-centers,and open-labeled study. The lymph node yield was significantly decreased in rectal cancer after neoadjuvant radiochemotherapy (NAT), hard for pathologists to detect, and is difficult to meet the guideline that minimun of 12 lymph nodes should be retrived after surgery in colorectal cancer. Carbon nanoparticle (CNP) is a specific lymph node tracer, which only dyeing the lymph node, and can keep the lymph node in dyeing state in at least half year. The inverstigator attempted to compare the amount of lymph node yield after surgery in locally advanced rectal caner between injection CNP before NAT and no injection CNP before NAT. In this study, the participants with clinical TNM stage T3+ or N+ will be recruited. The participants will be randomized (1:1 ratio) to a control and intervention arm. The participants in the control arm will not receive injection of any kind lymph node tracers. The participants in the intervention arm will receive injection of CNP before NAT. And the specimen would be evaluated by the pathologist.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
252
Injection carbon nanoparticle via rectal mucosa before neoadjuvant therapy
lymph node yield
Amount of lymph node yield, dyeing lymph node, positive lymph node and the dyeing positive lymph node
Time frame: up to 30days after total mesorectal excision
Impact on surgical operations
The impact of CNP to operational level
Time frame: Time of surgery
Quality of surgery
Quality of surgery determined using the mesorectal grading system
Time frame: Time of surgery
Surgery morbidity
Surgical morbidity reported according to Clavien-Dindo classification
Time frame: 30 days and 12-months
Overall survival
Overall Survival is defined as the time from the date of surgery to the date of death
Time frame: 5-years
Disease free survival
Disease Free Survival is defined as the time from the date of surgery to the date of the local recurrence, and/or distant disease, or tumor-related death
Time frame: 5-years
Local recurrence rate
Local recurrence rate is defined as the time from the date of surgery to the date of the local recurrence
Time frame: 5-years
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