Cancer Research and Treatment

Special Article

The Cancer Clinical Library Database (CCLD) from the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) Project: Sangwon Lee, Yeon Ho Choi, Hak Min Kim, Min Ah Hong, Phillip Park, In Hae Kwak, Ye Ji Kang, Kui Son Choi, Hyun-Joo Kong, Hyosung Cha, Hyun-Jin Kim, Kwang Sun Ryu, Young Sang Jeon, Hwanhee Kim, Jip Min Jung, Jeong-Soo Im, Heejung Chae; Received February 27, 2024 Accepted July 9, 2024 Published online July 15, 2024; DOI: https://doi.org/10.4143/crt.2024.218 [Epub ahead of print]

Abstract PDF PubReader ePub: The common data model (CDM) has found widespread application in healthcare studies, but its utilization in cancer research has been limited. This article describes the development and implementation strategy for Cancer Clinical Library Databases (CCLDs), which are standardized cancer-specific databases established under the Korea-Clinical Data Utilization Network for Research Excellence (K-CURE) project by the Korean Ministry of Health and Welfare. Fifteen leading hospitals and fourteen academic associations in Korea are engaged in constructing CCLDs for 10 primary cancer types. For each cancer type-specific CCLD, cancer data experts determine key clinical data items essential for cancer research, standardize these items across cancer types, and create a standardized schema. Comprehensive clinical records covering diagnosis, treatment, and outcomes, with annual updates, are collected for each cancer patient in the target population, and quality control is based on six-sigma standards. To protect patient privacy, CCLDs follow stringent data security guidelines by pseudonymizing personal identification information and operating within a closed analysis environment. Researchers can apply for access to CCLD data through the K-CURE portal, which is subject to Institutional Review Board and Data Review Board approval. The CCLD is considered a pioneering standardized cancer-specific database, significantly representing Korea’s cancer data. It is expected to overcome limitations of previous CDMs and provide a valuable resource for multicenter cancer research in Korea.

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Original Article

Gastrointestinal cancer

Association of Body Mass Index with Survival in Asian Patients with Colorectal Cancer: Sangwon Lee, Dong Hee Lee, Jae-Hoon Lee, Su-Jin Shin, Hye Sun Lee, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, Jeonghyun Kang; Cancer Res Treat. 2022;54(3):860-872. Published online October 15, 2021; DOI: https://doi.org/10.4143/crt.2021.656

Abstract PDF Supplementary Material PubReader ePub

Purpose
The clinical significance of body mass index (BMI) on long-term outcomes has not been extensively investigated in Asian patients with colorectal cancer (CRC). This study aims to describe the association between BMI and survival, plus providing BMI cut-off value for predicting prognosis in CRC patients.
Materials and Methods
A total of 1,182 patients who had undergone surgery for stage I-III CRC from June 2004 to February 2014 were included. BMI was categorized into four groups based on the recommendation for Asian ethnicity. The optimal BMI cut-off value was determined to maximize overall survival (OS) difference.
Results
In multivariable analysis, underweight BMI was significantly associated with poor OS (hazard ratio [HR], 2.38; 95% confidence interval [CI], 1.55 to 3.71; p < 0.001) and obese BMI was associated with better OS (HR, 0.72; 95% CI, 0.53 to 0.97; p=0.036) compared with the normal BMI. Overweight and obese BMI were associated with better recurrence-free survival (HR, 0.64; 95% CI, 0.42 to 0.99; p=0.046 and HR, 0.58; 95% CI, 0.38 to 0.89; p=0.014, respectively) compared with the normal BMI group. BMI cutoff value was 20.44 kg/m². Adding the BMI cutoff value to cancer staging could increase discriminatory performance in terms of integrated area under the curve and Harrell’s concordance index.
Conclusion
Compared to normal BMI, underweight BMI was associated with poor survival whereas obese BMI was associated with better survival. BMI cut-off value of 20.44 kg/m² is a useful discriminator in Asian patients with CRC.

Citations

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