My goal is to determine the clinical role of a minimally invasive therapy - percutaneous radiofrequency ablation (RFA) - for patients with small, incidentally detected renal tumors, by comparing RFA to surgery, the current standard of care. 1 will accomplish this goal using a decision-analytic approach. First, I will estimate the long-term effectiveness of RFA and surgery by developing a computer model that simulates the natural history of incidentally detected renal tumors, based on data from the literature and the SEER cancer registry. Second, I will collect patient data to improve quality-of-life and cost estimates associated with RFA and surgery, respectively - these estimates are either unavailable or insufficiently reported in the literature to, date. Third, I will perform a cost-effectiveness analysis in which I will compare RFA to surgery, using the effectiveness, quality-of-life, and cost data obtained. Finally, I will perform an extensive, probabilistic sensitivity analysis to estimate the uncertainty associated with analysis results. My career objective is to improve cancer outcomes by defining the best roles for imaging-based technologies in the care of cancer patients. I have pursued a unique career path that integrates cancer outcomes research, decision analysis, and radiology. I am part of a clinical division that serves as a large referral center for renal tumor RFA, and an outcomes research institute that has a wealth of resources to support decision analysis research. I have formulated a multidisciplinary team in decision science, epidemiology, radiology, urology, oncology, and pathology who currently advise in my research and career development, and will continue to do so during the award period. The research and career development plan that I outline in this proposal will provide me with a solid foundation for ongoing renal tumor therapy evaluation, from which I will transition to an independent investigator and leader in cancer outcomes research.

Public Health Relevance

My research will establish the role of percutaneous radiofrequency ablation - a minimally invasive tumor therapy - in the treatment of small, incidentally detected renal tumors. Insights from my research will improve practice guidelines for the use of radiofrequency ablation, and may ultimately preclude the need for surgery in patients with small, incidentally detected renal tumors.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Academic/Teacher Award (ATA) (K07)
Project #
1K07CA133097-01A2
Application #
7740533
Study Section
Subcommittee G - Education (NCI)
Program Officer
Perkins, Susan N
Project Start
2009-09-03
Project End
2014-06-30
Budget Start
2009-09-03
Budget End
2010-06-30
Support Year
1
Fiscal Year
2009
Total Cost
$178,657
Indirect Cost
Name
Massachusetts General Hospital
Department
Type
DUNS #
073130411
City
Boston
State
MA
Country
United States
Zip Code
02199
Hur, Chin; Tramontano, Angela C; Dowling, Emily C et al. (2016) Early Pancreatic Ductal Adenocarcinoma Survival Is Dependent on Size: Positive Implications for Future Targeted Screening. Pancreas 45:1062-6
Pandharipande, Pari V; Heberle, Curtis; Dowling, Emily C et al. (2015) Targeted screening of individuals at high risk for pancreatic cancer: results of a simulation model. Radiology 275:177-87
Lowry, Kathryn P; Turan, Ekin A; Eisenberg, Jonathan et al. (2015) Projected Effects of Radiation-Induced Cancers on Life Expectancy in Patients Undergoing CT Surveillance for Limited-Stage Hodgkin Lymphoma: A Markov Model. AJR Am J Roentgenol 204:1228-33
Eisenberg, Jonathan D; Gervais, Debra A; Singh, Sarabjeet et al. (2015) Radiation exposure from CT-guided ablation of renal masses: effects on life expectancy. AJR Am J Roentgenol 204:335-42
Kang, Stella K; Huang, William C; Pandharipande, Pari V et al. (2014) Solid renal masses: what the numbers tell us. AJR Am J Roentgenol 202:1196-206
Kiatpongsan, Sorapop; Meng, Lesley; Eisenberg, Jonathan D et al. (2014) Imaging for appendicitis: should radiation-induced cancer risks affect modality selection? Radiology 273:472-82
Eisenberg, Jonathan D; Lewin, Sarah O; Pandharipande, Pari V (2014) The fisherman's cards: how to address past and future radiation exposures in clinical decision making. AJR Am J Roentgenol 202:362-7
Kang, Stella K; Turan, Ekin A; Eisenberg, Jonathan D et al. (2014) Microsimulation model of CT versus MRI surveillance of Bosniak IIF renal cystic lesions: should effects of radiation exposure affect selection of imaging strategy? AJR Am J Roentgenol 203:W629-36
Eisenberg, Jonathan D; Gilmore, Michael E; Kalra, Mannudeep K et al. (2014) Prioritizing examination-centered over patient-centered dose reduction: a hazard of institutional ""benchmarking"". AJR Am J Roentgenol 202:1062-8
Lam, Diana L; Pandharipande, Pari V; Lee, Janie M et al. (2014) Imaging-based screening: understanding the controversies. AJR Am J Roentgenol 203:952-6

Showing the most recent 10 out of 22 publications