Mining the ACCENT database: a review and update

The database of the Adjuvant Colon Cancer End Points (ACCENT) Group was assembled to address questions in early stage colon cancer that could be best answered by information pooled across many similar trials. Today, the ACCENT database contains individual patient-level data from over 33,000 patients enrolled onto 25 adjuvant colon cancer trials conducted between 1977 and 2008. Since its flagship analysis of 3-year disease-free survival as a surrogate endpoint for 5-year overall survival in 2005, the ACCENT group has produced many noteworthy scientific findings addressing a variety of clinical questions, which we describe here. Additionally, we provide an overview of the history, collaboration, construction, principles, and future of the ACCENT database, as it has set a precedent for multi-trial database creation in other types of cancer.