Predictors of Outcome in Colorectal Cancer

结直肠癌结果的预测因素

• 批准号: 7101056
• 负责人: JEFFREY A MEYERHARDT
• 金额: $ 13.66万
• 依托单位: DANA-FARBER CANCER INST
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-08-01 至 2008-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7101056
• 关键词: body physical activity; clinical research; colorectal neoplasms; diet; dietary carbohydrates; dietary lipid; folate; health services research tag; hospital analysis; hospital utilization; human data; lifestyle; neoplasm /cancer classification /staging; neoplasm /cancer relapse /recurrence; nutrition related neoplasm /cancer; obesity; outcomes research; prognosis; toxicology

DESCRIPTION (provided by applicant): In 2001, approximately 135,400 Americans are expected to develop colorectal cancer, and 56,700 individuals will die from the disease. Though 80% of patients present at a stage when all apparent diseased tissue can be surgically resected, up to 40% of these patients will suffer from recurrence. Depth of tumor invasion and nodal status are considered the most important predictors of recurrence, and are the primary factors used by clinicians in recommending to patients adjuvant therapy after surgery. However, there is considerable variation in the outcome of patients with colorectal cancer not explained by traditional prognostic factors. The candidate for this award will utilize databases from two large, randomized adjuvant therapy trials to study other prognostic factors on outcomes in colon and rectal cancer. Specifically, these databases provide an opportunity to study the influence of potential modifiable treatment and patient characteristics on short- and long-term outcomes in patients with potentially curable colon and rectal cancers treated with surgery and adjuvant therapy. The specific aims of this proposal are (1) to examine whether hospital surgical volume and hospital characteristics affect cancer recurrence, overall survival, and treatment-related toxicity in patients undergoing curative surgery and adjuvant therapy for stages II and III rectal cancer, and (2) to examine the impact of diet and lifestyle on colon cancer recurrence and survival. Completion of these projects will improve our understanding of how potentially modifiable factors affect outcomes in patients treated with curative surgery and standard adjuvant therapy. These projects will provide insight into dietary and lifestyle behaviors of patients with colon cancer and which behaviors impact outcomes. Finally, these projects will allow the candidate to gain invaluable experience in database analysis and clinical epidemiologic and health outcomes research. The candidate will complete a Masters in Public Health (MPH) degree and advanced courses at the Harvard School of Public Health during the first two years of the proposed award. The projects will be performed under the mentorship of Dr. Charles Fuchs, a well-established researcher in prevention and health services research. At the completion of the project, the candidate will have gained the experience to become an independent researcher in clinical epidemiologic and health outcomes research.

描述(申请人提供)：2001年，大约135,400名美国人预计将患上结直肠癌，56,700人将死于这种疾病。虽然80%的患者处于可以通过手术切除所有明显病变组织的阶段，但这些患者中高达40%的患者将遭受复发。肿瘤的侵袭深度和淋巴结状态被认为是最重要的复发预测因素，也是临床医生推荐患者术后辅助治疗的主要因素。然而，结直肠癌患者的预后有相当大的差异，这不是传统预后因素所能解释的。 该奖项的候选人将利用两个大型随机辅助治疗试验的数据库来研究影响结肠癌和直肠癌预后的其他预后因素。具体地说，这些数据库提供了一个机会，可以研究潜在的可修改治疗方法和患者特征对接受手术和辅助治疗的潜在可治愈结肠癌和直肠癌患者的短期和长期结果的影响。这项建议的具体目的是(1)研究医院手术量和医院特征是否影响接受根治性手术和辅助治疗的II期和III期直肠癌患者的癌症复发、总存活率和治疗相关毒性，以及(2)研究饮食和生活方式对结肠癌复发和存活率的影响。 这些项目的完成将提高我们对潜在的可修改因素如何影响接受根治性手术和标准辅助治疗的患者的结果的理解。这些项目将提供对结肠癌患者的饮食和生活方式行为的洞察，以及哪些行为影响结果。最后，这些项目将使应聘者在数据库分析和临床流行病学和健康结果研究方面获得宝贵的经验。候选人将在拟议奖项的头两年完成哈佛公共卫生学院的公共卫生硕士学位和高级课程。这些项目将在查尔斯·福克斯博士的指导下实施，福克斯博士是预防和卫生服务研究领域的知名研究员。在项目完成时，候选人将获得成为临床流行病学和健康结果研究的独立研究员的经验。