King's Health Partners Cohort

King's Health Partners Cohort

A Prostate Cancer Clinical Database is currently being set up at King’s Health Partners (KHP) allowing all those involved in prostate cancer research vital access to data and clinical specimens from all patients. This database will contain both retrospective and prospective information and aims to contain about 5,000 newly diagnosed cases over the next 5 years. In addition to these prospective cohorts, we have identified two retrospective studies using information from medical records and tissue taken for diagnostic purposes. Please note that we are currently in the process of getting all this information into one database, which is coordinated by Aida Santaollala (clinical database manager) and John Brown (Research Scientist in Breast and Prostate Pathology). Please see below for a detailed description of our prospective and retrospective data collection as well as some of the study cohorts we have identified.

(1) Prospective Data Collection

The prospective collection of data from men diagnosed with prostate cancer at KHP started in March 2012. We are using data from the Electronic Patient Records (EPR) and Cancer Information System (CIS) software, which is populated during the weekly Multidisciplinary Team Meetings where newly diagnosed patients are being discussed. We are capturing information on primary diagnosis, tumour diagnosis, primary treatment, serum lipids, and follow-up outcome variables. The Prostate Cancer Access Committee of KHP, led by Massimo Loda, regulates access to both clinical information and tissue captured by our Clinical Database. Once consenting and linkage with diagnostic tissue is fully in place, we are also aiming to collect 3x10ml blood samples from each patient.

(2) Retrospective Data Collection

We estimate that about 5,000 patients were diagnosed between 1990 and 2011. We collected these numbers from both hospital data and the nationally regulated Thames Cancer Registry. All clinical information for these patients is stored using different hospital software systems and we are currently in the process of linking all of these to ensure that information is captured consistent with the forms used by the National Prostate Cancer Register of Sweden. All of this is done in close collaboration with the Urology, Oncology, and Radiology Departments. Archived tissue from diagnostic procedures is available for the majority of patients. KHP’s Prostate Cancer Access Committee, which is led by Massimo Loda, regulates access to clinical information as well as tissue.

Thus, as merging and assessment of data and tissue for all these patients is labour intensive, we are focusing on the establishment of a case-control study and a cohort study using information from the detailed clinical cohorts (see figure above):

(1) Metastatic Recurrence Case-Control Study: A case is a person who develops a metastatic recurrence after diagnosis (index date) and a control is a man who developed PCa around the same time but did not develop a metastatic recurrence at the index date. Cases and controls are matched on disease risk category and ‘clinical cohort’.

(2) Metastatic Diagnosis Cohort Study: Exposure is defined as presenting with metastasis at time of diagnosis. The control cohort consists of men who do not have a metastatic prostate cancer at time of diagnosis. Exposed men and controls are matched on ‘Clinical cohort’.

Clinical information and tissue from diagnostics will be available for all cases and controls. We are planning to have data collection finished by 31 August and related TMAs by 31 December 2013.

Ultimately, we are aiming to obtain all the above information for all men in our retrospective cohort.

(3) King’s Health Partners’ Lipid Study

Between 2001 and 2004, 204 patients with localized prostate cancer underwent a detailed assessment of their history and coexistence of comorbidities. In the context of lipid profiles, the following information was obtained: blood levels of total cholesterol (TC), HDL and LDL cholesterol, triglycerides (TG), and apolipoproteins (Apo) A-I and B. We have finalized collecting follow-up information in terms of clinical outcomes. In addition, we have obtained new serum lipid profiles for 74 patients as well as two blood samples for future research purposes. CMOP (Dana Farber) is currently staining tissue for markers of FAS/AMPK for about 60 patients.