Colorectal cancer incidence has been rising strongly in parallel with economic development.In the past few decades,much has been learned about the lifestyle,dietary and medication risk factors for this malignancy.With...Colorectal cancer incidence has been rising strongly in parallel with economic development.In the past few decades,much has been learned about the lifestyle,dietary and medication risk factors for this malignancy.With respect to lifestyle,compelling evidence indicates that prevention of weight gain and maintenance of a reasonable level of physical activity can positively influence in lowering the risk.Although there is controversy about the role of specific nutritional factors,consideration of dietary pattern as a whole appears useful for formulating recommendations.Though quite often recommended,the role for many supplements,including omega-3,vitamin D,folate,and vitamin B6,remains unsettled.Only calcium and vitamin D supplementation appear to add a modest benefit,particularly in those with a low daily intake.With regard to chemoprevention,medications such as aspirin and nonsteroidal antiinflammatory drugs,and postmenopausal hormonal replacement for women might be associated with substantial reductions in colorectal cancer risk,though their utility is affected by their side effect profile.However,the role of agents such as statins,bisphosphonates and antioxidants have yet to be determined.Ultimately,primary prevention strategies focusing on modifying environmental,lifestyle risk factors,and chemopreventive drugs are options that have already been tested,and may impact on colon cancer incidence.展开更多
AIM To verify whether recurrence-free survival(RFS) surrogates overall survival(OS) in phase Ⅲ trials for resectable colorectal liver metastases(CRLM).METHODS MEDLINE,EMBASE,and Scopus databases were consulted.Eligib...AIM To verify whether recurrence-free survival(RFS) surrogates overall survival(OS) in phase Ⅲ trials for resectable colorectal liver metastases(CRLM).METHODS MEDLINE,EMBASE,and Scopus databases were consulted.Eligible studies were phase Ⅲ trials testing any type of systemic therapy(neoadjuvant,adjuvant or perioperative) added to surgery in patients with resectable CRLM.A linear regression model based on hazard ratios(HR) of OS and RFS was performed.RESULTS Of 3059 studies,5 phase Ⅲ trials(1162 patients) were included for analyses.A linear regression weighted by each trial was used to estimate the association between each HR and RFS.The originated formula was:OS HR =(0.93 × RFS HR) + 0.14;with RFS 95%CI(0.48-1.38),with P = 0.007.CONCLUSION This association suggests that RFS could work as a putative surrogate endpoint of OS in this population,avoiding bigger,longer and more resource-consuming trials.The OS could be assumed based on RFS and our model could be useful to better estimate sample size calculations of phase Ⅲ trials of CRLM aiming for OS.展开更多
文摘Colorectal cancer incidence has been rising strongly in parallel with economic development.In the past few decades,much has been learned about the lifestyle,dietary and medication risk factors for this malignancy.With respect to lifestyle,compelling evidence indicates that prevention of weight gain and maintenance of a reasonable level of physical activity can positively influence in lowering the risk.Although there is controversy about the role of specific nutritional factors,consideration of dietary pattern as a whole appears useful for formulating recommendations.Though quite often recommended,the role for many supplements,including omega-3,vitamin D,folate,and vitamin B6,remains unsettled.Only calcium and vitamin D supplementation appear to add a modest benefit,particularly in those with a low daily intake.With regard to chemoprevention,medications such as aspirin and nonsteroidal antiinflammatory drugs,and postmenopausal hormonal replacement for women might be associated with substantial reductions in colorectal cancer risk,though their utility is affected by their side effect profile.However,the role of agents such as statins,bisphosphonates and antioxidants have yet to be determined.Ultimately,primary prevention strategies focusing on modifying environmental,lifestyle risk factors,and chemopreventive drugs are options that have already been tested,and may impact on colon cancer incidence.
文摘AIM To verify whether recurrence-free survival(RFS) surrogates overall survival(OS) in phase Ⅲ trials for resectable colorectal liver metastases(CRLM).METHODS MEDLINE,EMBASE,and Scopus databases were consulted.Eligible studies were phase Ⅲ trials testing any type of systemic therapy(neoadjuvant,adjuvant or perioperative) added to surgery in patients with resectable CRLM.A linear regression model based on hazard ratios(HR) of OS and RFS was performed.RESULTS Of 3059 studies,5 phase Ⅲ trials(1162 patients) were included for analyses.A linear regression weighted by each trial was used to estimate the association between each HR and RFS.The originated formula was:OS HR =(0.93 × RFS HR) + 0.14;with RFS 95%CI(0.48-1.38),with P = 0.007.CONCLUSION This association suggests that RFS could work as a putative surrogate endpoint of OS in this population,avoiding bigger,longer and more resource-consuming trials.The OS could be assumed based on RFS and our model could be useful to better estimate sample size calculations of phase Ⅲ trials of CRLM aiming for OS.
