Nevers

Diabetic foot ulcer DFU is a common and serious complication in people with diabetes, often leading to lower-limb amputation and linked to decreased quality of life and increased health care costs. This research aims to better understand why patients with DFU have a higher risk of premature death, exploring factors beyond cardiovascular disease such as inflammation, infections, and cancers. The study is a prospective, observational, multi-center cohort conducted in France. Adults with diabetes and DFU will be followed for up to 5 years to measure outcomes including mortality rates, causes of death, and prognostic factors. The study will include a 3-year enrollment period starting in 2020. Researchers will also assess changes in health-related quality of life and the economic burden of DFU using healthcare claims data. Participants will be monitored regularly over 5 years or until death. Researchers will collect data on survival without active or recurrent DFU, major limb and vascular events, and overall health status. The study will provide important data on the course of DFU and its impact on patients lives and health care systems.

Colorectal cancer mostly affects elderly patients, with over half diagnosed at age 70 or older in France. This research evaluates the benefit of adjuvant chemotherapy after surgical removal of stage III colon cancer in elderly patients, focusing on whether fluoropyrimidine-based or oxaliplatin-based chemotherapy improves disease-free survival. The study addresses concerns about the effectiveness of chemotherapy in very elderly or unfit patients and includes an assessment of tumor biological factors common in the elderly. Participants are divided into two groups based on a doctors evaluation involving a geriatrician, with different randomization assignments. Treatments being studied include chemotherapy regimens with LV5FU2 or capecitabine and FOLFOX4 or XELOX, as well as observation. The chemotherapy is started within 12 weeks after surgery. The study compares these approaches to determine the best adjuvant chemotherapy strategy for elderly patients. During the study, participants undergo assessments including geriatric questionnaires and monitoring of toxicities. Researchers measure disease-free survival three years after the last patient joins, along with overall survival at five years. Safety is evaluated by observing side effects graded by standard criteria. The study excludes patients with less than four years expected survival and ensures medical follow-up is possible. Participation duration and detailed monitoring support evaluating chemotherapy benefits in this population.