Predictors of Outcome in Colorectal Cancer

结直肠癌结果的预测因素

• 批准号: 6678510
• 负责人: JEFFREY A MEYERHARDT
• 金额: $ 13.57万
• 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/6678510
• 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（由申请人提供）：2001年，预计大约有135,400名美国人将发展结直肠癌，56,700个人将死于该疾病。 尽管有80％的患者在所有明显的组织可以通过手术切除的阶段出现，但这些患者中有40％的患者会复发。 肿瘤侵袭和淋巴结状态的深度被认为是复发的最重要预测指标，是临床医生在手术后建议患者辅助治疗的主要因素。 但是，结直肠癌患者的结果有很大差异，没有传统的预后因素来解释。 该奖项的候选人将利用来自两个大型的随机辅助治疗试验的数据库来研究结肠和直肠癌结果的其他预后因素。 具体而言，这些数据库提供了一个机会，可以研究潜在可修改治疗和患者特征对接受手术和辅助治疗治疗的潜在可治愈结肠和直肠癌患者的短期和长期结局的影响。 该提案的具体目的是（1）检查医院手术量和医院特征是否会影响接受治疗手术的患者的癌症复发，整体生存和与治疗相关的毒性以及II和III阶段的辅助治疗，以及（2 ）检查饮食和生活方式对结肠癌复发和生存的影响。 这些项目的完成将提高我们对可修改因素如何影响治疗手术和标准辅助治疗患者的预后的理解。 这些项目将洞悉结肠癌患者的饮食和生活方式行为，哪些行为影响结果。 最后，这些项目将使候选人能够在数据库分析和临床流行病学和健康成果研究中获得宝贵的经验。 候选人将在拟议奖项的前两年完成哈佛公共卫生学院的公共卫生硕士学位（MPH）学位和高级课程。 这些项目将在预防和卫生服务研究方面成就良好的研究人员Charles Fuchs博士的指导下进行。 该项目完成后，候选人将获得成为临床流行病学和健康成果研究的独立研究人员的经验。