Official websites use .gov

A .gov website belongs to an official government organization in the United States.

Secure .gov websites use HTTPS

A lock ( 🔒 ) or https:// means you've safely connected to the .gov website. Share sensitive information only on official, secure websites.

Need Help

IDENTIFYING SUBGROUPS WITH LOCALIZED KIDNEY CANCER WHO CAN DEFER SURGERY

Award Number: R03CA152388
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 04/01/2011
PERIOD OF PERFORMANCE END DATE: 03/31/2013

Group Awards By:

View Award Description

IDENTIFYING SUBGROUPS WITH LOCALIZED KIDNEY CANCER WHO CAN DEFER SURGERY - DESCRIPTION (provided by applicant): The incidence of localized kidney cancer has been increasing for the past several decades. Much of this increase is likely due to the detection of small tumors found incidentally after ultrasound, CT scans, or MRI scans ordered for non-kidney cancer related reasons. This suggests two possibilities:1) many tumors that would previously have been found at a later stage are simply being found at earlier stages, and 2) tumors that would never have progressed to a symptomatic or lethal stage are now being found. The possibility that biologically inconsequential small renal masses are now being detected has opened a debate concerning the benefits of active surveillance prior to or in lieu of surgical or other interventions for the treatment of small localized renal masses. Many patients who are treated with surgery will die from other diseases within five years of treatment. The survival benefit of therapy for kidney cancer is hence modest for patients who would die within five years regardless of therapy. Further, there is some evidence that certain treatments might actually worsen survival outcomes in some patients with localized kidney cancer. Radical nephrectomy, for example, has been associated with an increased risk of chronic kidney disease (CKD) compared to partial nephrectomy. Given the debate surrounding the appropriateness of treatment for localized kidney cancer, particularly among older patients and those with comorbidities, better prognostic models are needed to identify who might benefit from active surveillance (also called observation). The goal of this work is to improve prognostic modeling by developing models that can classify individuals according to their underlying hazard of death either with or without treatment. We will apply the models using linked SEER-Medicare data. The importance of accounting for heterogeneity of progression or mortality rates has already been noted in the medical decision making literature. However, such methods often assume that individuals are either rapid or slow disease progressors. This research, in contrast, proposes the development of models that can identify four potential survival rate groups in the investigation of clinical effectiveness: 1) those that have long survival with or without treatment who can therefore be observed, 2) those that have short survival without treatment but long survival with treatment who should hence undergo immediate intervention, 3) those that have long survival without treatment but short survival with treatment who should be observed, and 4) those that have short survival with or without treatment who can avoid unnecessary surgery. Further, we assume that relatively long and short survival hazards can vary between treatment arms. We propose using principal stratification and Rubin's causal model as conceptual tools for this investigation. This project will further knowledge concerning heterogeneity in survival rates among those with localized kidney cancer. PUBLIC HEALTH RELEVANCE: This work will improve prognostic modeling of localized kidney cancer outcomes by developing models that can classify individuals according to their underlying hazard of death either with or without treatment. Those whose life expectancy would not change or would worsen with treatment could be spared surgery.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2012 ( Subtotal = $89,126 )
2012	2012	FOX CHASE CANCER CENTER	7701 BURHOLME AVENUE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Cancer Cause and Prevention Research	000	2	3/22/2012	NON-COMPETING CONTINUATION	$89,126
														Subtotal = $89,126

Issue Date FY: 2011 ( Subtotal = $88,438 )
2011	2011	FOX CHASE CANCER CENTER	7701 BURHOLME AVENUE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Cancer Cause and Prevention Research	001	1	3/10/2011	NEW	$1,188
2011	2011	FOX CHASE CANCER CENTER	7701 BURHOLME AVENUE	PHILADELPHIA	PA	19111	PHILADELPHIA	USA	Cancer Cause and Prevention Research	000	1	2/18/2011	NEW	$87,250
														Subtotal = $88,438

Grand Total All Awards = $177,564

Top

All Categories

About

Search

Reports

Data Submission

Award Information

IDENTIFYING SUBGROUPS WITH LOCALIZED KIDNEY CANCER WHO CAN DEFER SURGERY

Award Number: R03CA152388

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 04/01/2011

PERIOD OF PERFORMANCE END DATE: 03/31/2013

Federal Websites

Department of Health & Human Services

HHS Operating Divisions

HHS Staff Divisions

Download A Document Viewer