Characterising Metastatic Penile Cancer Using Molecular Imaging - Hybrid MRI-PET [MRI-PET]

NCT02104063 | Completed

• 1 other identifier: 008956QM
• Study Type: observational
• Target: 78
• Locations: 1 country
• Sites: 1

Brief Summary

The presence of metastatic disease in the lymph nodes within the groin is the most important factor in predicting the long-term outcome for patients diagnosed with penile cancer. In the majority of patients diagnosed with penile cancer obvious abnormalities cannot be felt in the groin even though the cancer may have already spread to the lymph nodes in the groin. In these patients, a procedure called Dynamic Sentinel Lymph Node Biopsy (DSLB) is required to determine if the cancer has spread to the lymph nodes in the groin. In DSLB a radioactive substance is injected at the site of the penile cancer and then travels to the lymph nodes in the groin which are then biopsied. This procedure requires a general anaesthetic and an in-patient hospital stay. In approximately 20% of patients with penile cancer obvious abnormalities can be felt in the lymph nodes in the groin. However, any abnormality detected may not necessarily be due to metastatic disease. In order to confirm if metastatic disease is present in the lymph nodes of these patients a biopsy is also required. However in these patients the lymph nodes are detected and biopsied using an ultrasound scan rather than by passing a radioactive substance into the body. MRI-PET is a new procedure which combines conventional MRI (Magnetic Resonance Imaging) and PET (Positron Emission Tomography) scans into one scan. MRI - PET scans create very clear pictures of internal body structures. MRI-PET is a non-invasive procedure which can be performed on an out-patient basis. The accuracy of MRI-PET in detecting metastatic penile cancer is not known. The main purpose of this study is to establish the effectiveness of MRI-PET compared to DSLB and ultrasound guided biopsy in detecting the presence of metastatic disease in the lymph nodes of patients with penile cancer. If effective, MRI-PET could replace the invasive procedures currently required for detection of metastatic penile cancer.

Conditions

Squamous Cell Carcinoma of the Penis

Outcome Measures

Primary Outcomes (1)

• Evaluating the clinical validity (sensitivity, specificity, negative and positive predictive values) of whole-body MRI-PET to detect or exclude micrometastatic disease in inguinal lymph nodes.

  Evaluating the clinical validity (sensitivity, specificity, negative and positive predictive values) of whole-body MRI-PET imaging to detect or exclude micrometastatic disease in inguinal lymph nodes in patients diagnosed with squamous cell carcinoma of the penis using dynamic sentinel lymph node biopsy as the reference standard for clinically impalpable inguinal lymph nodes and ultrasound guided fine needle aspiration/ excisional biopsy as the reference standard in patients with clinically palpable inguinal lymph nodes.

  3 years

Study Arms (1)

MRI-PET

Participants will have an MRI-PET scan (the Index test) in addition to the procedures they would normally receive as their standard of care (Reference tests). The accuracy of MRI-PET in detecting or ruling out metastatic penile cancer will be compared to the reference tests.

Procedure: MRI-PET

Interventions

MRI-PET PROCEDURE

Participants will have an MRI-PET scan (the Index test) in addition to the procedures they would normally receive as their standard of care (Reference tests). The accuracy of MRI-PET in detecting or ruling out metastatic penile cancer will be compared to the reference tests.

MRI-PET

Eligibility Criteria

• Age: 18 Years+
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients referred to UCLH presenting with penile cancer will be approached for consideration of inclusion into the study.

You may qualify if:

• Squamous cell carcinoma of the penis.
• Men aged \>= 18 years.
• Willing and able to give written informed consent prior to study entry.
• Patients must be sterile or agree to use adequate contraception during the study period.

You may not qualify if:

• Any co-existing medical condition that in the Investigator's judgement will substantially increase the risk associated with the patient's participation in the study.
• Any known contraindication to MRI such as ferrous metal implants, electrical implants (e.g. cochlear implants, cardiac pacemaker), or history of injury involving metal fragments.
• Any known contraindication to PET scans.
• Any known allergy to FDG (18F-2-fluoro-2-deoxy-D-glucose fluorodeoxyglucose).
• Uncontrolled diabetes.
• Inability to comply with the study procedures.
• Medical or psychiatric illness, which makes the patient unsuitable or unable to give informed consent.

Sponsors & Collaborators

• Queen Mary University of London: lead

Study Sites (1)

University College London Hospitals

London, NW1 2BU, United Kingdom

Location

Related Publications (16)

• Parkin DM, Muir CS. Cancer Incidence in Five Continents. Comparability and quality of data. IARC Sci Publ. 1992;(120):45-173. No abstract available.

  PMID: 1284606 BACKGROUND

• Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin. 2007 Jan-Feb;57(1):43-66. doi: 10.3322/canjclin.57.1.43.

  PMID: 17237035 BACKGROUND

• Srinivas V, Morse MJ, Herr HW, Sogani PC, Whitmore WF Jr. Penile cancer: relation of extent of nodal metastasis to survival. J Urol. 1987 May;137(5):880-2. doi: 10.1016/s0022-5347(17)44281-9.

  PMID: 3573181 BACKGROUND

• Ravi R. Correlation between the extent of nodal involvement and survival following groin dissection for carcinoma of the penis. Br J Urol. 1993 Nov;72(5 Pt 2):817-9. doi: 10.1111/j.1464-410x.1993.tb16273.x.

  PMID: 8281416 BACKGROUND

• Horenblas S, van Tinteren H. Squamous cell carcinoma of the penis. IV. Prognostic factors of survival: analysis of tumor, nodes and metastasis classification system. J Urol. 1994 May;151(5):1239-43. doi: 10.1016/s0022-5347(17)35221-7.

  PMID: 8158767 BACKGROUND

• Lont AP, Kroon BK, Gallee MP, van Tinteren H, Moonen LM, Horenblas S. Pelvic lymph node dissection for penile carcinoma: extent of inguinal lymph node involvement as an indicator for pelvic lymph node involvement and survival. J Urol. 2007 Mar;177(3):947-52; discussion 952. doi: 10.1016/j.juro.2006.10.060.

  PMID: 17296384 BACKGROUND

• Sanchez-Ortiz RF, Pettaway CA. The role of lymphadenectomy in penile cancer. Urol Oncol. 2004 May-Jun;22(3):236-44; discussion 244-5. doi: 10.1016/j.urolonc.2004.04.031.

  PMID: 15271324 BACKGROUND

• Pandey D, Mahajan V, Kannan RR. Prognostic factors in node-positive carcinoma of the penis. J Surg Oncol. 2006 Feb 1;93(2):133-8. doi: 10.1002/jso.20414.

  PMID: 16425300 BACKGROUND

• Ornellas AA, Kinchin EW, Nobrega BL, Wisnescky A, Koifman N, Quirino R. Surgical treatment of invasive squamous cell carcinoma of the penis: Brazilian National Cancer Institute long-term experience. J Surg Oncol. 2008 May 1;97(6):487-95. doi: 10.1002/jso.20980.

  PMID: 18425779 BACKGROUND

• Wespes E. The management of regional lymph nodes in patients with penile carcinoma and reliability of sentinel node biopsy. Eur Urol. 2007 Jul;52(1):15-6; discussion 20-1. doi: 10.1016/j.eururo.2007.02.045. Epub 2007 Mar 1. No abstract available.

  PMID: 17349735 BACKGROUND

• Protzel C, Alcaraz A, Horenblas S, Pizzocaro G, Zlotta A, Hakenberg OW. Lymphadenectomy in the surgical management of penile cancer. Eur Urol. 2009 May;55(5):1075-88. doi: 10.1016/j.eururo.2009.02.021. Epub 2009 Feb 23.

  PMID: 19264390 BACKGROUND

• Heyns CF, Fleshner N, Sangar V, Schlenker B, Yuvaraja TB, van Poppel H. Management of the lymph nodes in penile cancer. Urology. 2010 Aug;76(2 Suppl 1):S43-57. doi: 10.1016/j.urology.2010.03.001.

  PMID: 20691885 BACKGROUND

• Ficarra V, Zattoni F, Artibani W, Fandella A, Martignoni G, Novara G, Galetti TP, Zambolin T, Kattan MW; G.U.O.N.E. Penile Cancer Project Members. Nomogram predictive of pathological inguinal lymph node involvement in patients with squamous cell carcinoma of the penis. J Urol. 2006 May;175(5):1700-4; discussion 1704-5. doi: 10.1016/S0022-5347(05)01003-7.

  PMID: 16600735 BACKGROUND

• Leijte JA, Hughes B, Graafland NM, Kroon BK, Olmos RA, Nieweg OE, Corbishley C, Heenan S, Watkin N, Horenblas S. Two-center evaluation of dynamic sentinel node biopsy for squamous cell carcinoma of the penis. J Clin Oncol. 2009 Jul 10;27(20):3325-9. doi: 10.1200/JCO.2008.20.6870. Epub 2009 May 4.

  PMID: 19414668 BACKGROUND

• Horenblas S, van Tinteren H, Delemarre JF, Moonen LM, Lustig V, van Waardenburg EW. Squamous cell carcinoma of the penis. III. Treatment of regional lymph nodes. J Urol. 1993 Mar;149(3):492-7. doi: 10.1016/s0022-5347(17)36126-8.

  PMID: 8437253 BACKGROUND

• Hegarty PK, Kayes O, Freeman A, Christopher N, Ralph DJ, Minhas S. A prospective study of 100 cases of penile cancer managed according to European Association of Urology guidelines. BJU Int. 2006 Sep;98(3):526-31. doi: 10.1111/j.1464-410X.2006.06296.x.

  PMID: 16925747 BACKGROUND

Biospecimen

Retention: SAMPLES WITHOUT DNA

Whole blood, serum, biopsy tissue of primary penile cancer lesions and metastatic lesions.

Study Officials

• Manit Arya, MBChB, FRCS

  University College London Hospitals

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: November 18, 2013
• First Posted: April 4, 2014
• Study Start: July 22, 2013
• Primary Completion: July 22, 2016
• Study Completion: July 22, 2016
• Last Updated: March 10, 2025

Record last verified: 2025-03

Locations

GB (1)