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Special survivorship OPD for colorectal cancer patients to improve follow up

ABSTRACT: Intervention1: Arm B survivorship programme: Patients on Arm B will be randomized to the survivorship programme and will be followed up in a special survivorship clinic. The follow up clinic will be scheduled at a fixed time on alternate Tuesday. The team in the clinic will consist of specialist nurses trained in enterostomal therapy as well as counselling in addition to the clinicians (surgeon, oncologist, radiotherapist, gastroenterologist). The appointments will be managed by the clinic nurses. We will use telephonic reminders/ email or SMS alerts to remind patients about their follow up dates. In case of a missed appointment we will plan a telephonic interview on a day other than the routine clinic day). The follow up protocols will be similar. All patients with age less than 40 years will be referred to the genetic clinic. Patients with familial cancers will be managed as per standard guidelines. All data will be recorded in a CRF (Appendix 3) and entered into a prospective SPSS based database in the survivorship programme. Patients who are planned for treatment with a palliative intent or who are planned for Best Supportive Care (BSC) will be excluded. Control Intervention1: ARM A :standard follow up: Patients on Arm A will be randomized to standard follow up. These patients will be followed up in the regular clinic (general or private) along with other CRC patients as per current SOPs for surveillance and follow up (Appendix 1). Data will be evaluated at end of 2 years from Electronic Medical Records (EMR). Primary outcome(s): To evaluate whether a survivorship programme improves follow up in CRC patients treated with a curative intent.Timepoint: 5 years

DISEASE(S): Malignant Neoplasm Of Rectum,Malignant Neoplasm Of Colon

PROVIDER: 2587145 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Purpose: Patients with locally advanced prostate cancer after radical prostatectomy are candidates for secondary therapy. However, this higher risk population is heterogeneous. Many cases do not metastasize even when conservatively managed. Given the limited specificity of pathological features to predict metastasis, newer risk prediction models are needed. We report a validation study of a genomic classifier that predicts metastasis after radical prostatectomy in a high risk population. Method:A case-cohort design was used to sample 1,010 patients after radical prostatectomy at high risk for recurrence who were treated from 2000 to 2006. Patients had preoperative prostate specific antigen greater than 20 ng/ml, Gleason 8 or greater, pT3b or a Mayo Clinic nomogram score of 10 or greater. Patients with metastasis at diagnosis or any prior treatment for prostate cancer were excluded from analysis. A 20% random sampling created a subcohort that included all patients with metastasis. We generated 22-marker genomic classifier scores for 235 patients with available genomic data. ROC and decision curves, competing risk and weighted regression models were used to assess genomic classifier performance. Patients treated with RP between 2000 and 2006 were identified from the Mayo Clinic tumor registry for a case-cohort study design. This involved identification of all patients with metastasis and a representative of the full cohort .Thus, men at high risk of recurrence post-RP (open/robotic) with no prior neoadjuvant/prostate cancer treatment were selected based on any of preoperative PSA >20 ng/mL, pathological Gleason score (GS) â¥8, SVI, or GPSM (GS; preoperative PSA; SVI; margins) score â¥10.The cohort of 1,010 men included 73 cases with metastasis as evidenced by CT or bone scan. A 20% random sample (n=202) was drawn from the cohort. This included 19 of 73 metastatic cases. To increase sampling of metastasis, the remaining 54 metastatic cases were added, resulting in a final study set of 256 patients. 21 samples did not pass QC and were eliminated from this study. Patients not experiencing metastasis regardless of BCR (defined as follow-up PSA â¥0.4 ng/mL >30 days post-RP) were censored at last follow-up. The study was approved by Mayo Clinic Institutional Review Board.

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Special survivorship OPD for colorectal cancer patients to improve follow up

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