Database research part <b>Ⅹ</b>: feature analysis of adjuvant treatment of colorectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yong ¹ , WANG Xiaodong ¹ , ZHU Jiayi ² ,  LI Li ¹ , ZHOU Zongguang ¹

1. Department of Gastrointestinal Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Nursing, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LI Li, Email: drlili116@126.com

Keywords：

colorectal cancer; database; big data; adjuvant therapy; efficacy

DOI：

10.7507/1007-9424.202105044

Video：

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Objective To analyze the characteristics of adjuvant treatment of colorectal cancer in the Database from Colorectal Cancer (DACCA).Methods The informations in the DACCA database were screened, including adjuvant therapy (adjuvant strategy, compliance), adjuvant chemotherapy (indication selection, acceptance, actual cycles of chemotherapy, effect, and standardized application), adjuvant radiotherapy (indication selection, acceptance, and effect), and targeted therapy (uses of oral and intravenous targeted drugs). The data that at least one of items must not be “empty” were selected.Results A total of 3 955 data items were analyzed for colorectal cancer adjuvant therapy. ① The highest data composition ratio of “planned strategy of adjuvant therapy” and “compliance of adjuvant therapy” was “adjuvant therapy” (35.6%, 929/2 611) and “coordination” (28.1%, 664/2362), respectively. ② The highest data composition ratios of “indication of chemotherapy”, “acceptance of chemotherapy”, “cycles of chemotherapy”, “effect of chemotherapy”, and “chemotherapy based guidelines” were “must” (38.6%, 1 140/2 963), “rejection” (53.1%, 1 373/2 586), “6-cycle adjuvant chemotherapy” (12.4%, 338/2 722), “stability” (59.9%, 618/1031), and “standardization” (78.6%, 903/1 149). There was an obvious relationship between the planned strategy of adjuvant chemotherapy and the final acceptance of chemotherapy (χ²=505.262, P<0.001), that was, when the planned strategy of adjuvant chemotherapy was “optional”, the proportion of final rejection was very high (89.0%, 137/154). ③ The highest data composition ratios of “indication of radiation”, “acceptance of radiation”, and “effect of radiation” were “unnecessary” (49.1%, 1 423/2 915), “rejection” (93.8%, 2 629/2 803), and “stability” (38.1%, 45/118). There was a correlation between the planned strategy of adjuvant radiotherapy and the final acceptance of radiotherapy (χ²=139.593, P<0.001), that was, when the patients who should receive radiotherapy had not high acceptance (10.6%, 127/1 194), and the patients who should select optional radiotherapy all refused radiotherapy (100%).④ The data composition ratios of “none” of oral and intravenous targeted therapy drugs in targeted therapy were the highest, at 84.2% (2 121/2 520) and 73.3% (206/281), respectively. Conclusion By expounding the characteristics of the current adjuvant treatment of colorectal cancer in DACCA, it provides a reference for the adjuvant treatment of colorectal cancer.

Citation： LIU Yong, WANG Xiaodong, ZHU Jiayi, LI Li, ZHOU Zongguang. Database research part Ⅹ: feature analysis of adjuvant treatment of colorectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(7): 937-944. doi: 10.7507/1007-9424.202105044 Copy

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12.	Hawkins AT, Ford MM, Geiger TM, et al. Neoadjuvant radiation for clinical T4 colon cancer: A potential improvement to overall survival. Surgery, 2019, 165(2): 469-475.
13.	Kuan FC, Lai CH, Ku HY, et al. The survival impact of delayed surgery and adjuvant chemotherapy on stage Ⅱ/Ⅲ rectal cancer with pathological complete response after neoadjuvant chemoradiation. Int J Cancer, 2017, 140(7): 1662-1669.
14.	Nachiappan S, Askari A, Mamidanna R, et al. The impact of adjuvant chemotherapy timing on overall survival following colorectal cancer resection. Eur J Surg Oncol, 2015, 41(12): 1636-1644.
15.	刘勇, 汪晓东, 由屹先, 等. 数据库研究第九部分: 结直肠癌的新辅助治疗. 中国普外基础与临床杂志, 2021, 28(5): 657-663.
16.	汪晓东, 刘健博, 何欣林, 等. 数据库研究第六部分: 结直肠癌的分期策略. 中国普外基础与临床杂志, 2020, 27(6): 739-46.
17.	汪晓东, 孟鑫宇, 刘健博, 等. 数据库研究第八部分: 结直肠癌术后风险与并发症. 中国普外基础与临床杂志, 2021, 28(3): 369-375.
18.	Hasan S, Renz P, Wegner RE, et al. Microsatellite instability (MSI) as an independent predictor of pathologic complete response (PCR) in locally advanced rectal cancer: A National Cancer Database (NCDB) analysis. Ann Surg, 2020, 271(4): 716-723.
19.	Le DT, Durham JN, Smith KN, et al. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science, 2017, 357(6349): 409-413.

1. 刘健博, 由屹先, 邹雨恒, 等. 数据库辅助研究: 结直肠癌新辅助治疗的应用—基于 DACCA 的华西真实世界数据报道. 中国普外基础与临床杂志, 2019, 26(12): 1467-1475.
2. 汪晓东, 李立. 真实场景与大数据下的整体微创理念, 大幅提高结直肠癌远期生存率. 中国普外基础与临床杂志, 2019, 26(1): 92-95.
3. James S. Importance of post-approval real-word evidence. Eur Heart J Cardiovasc Pharmacother, 2018, 4(1): 10-11.
4. Santinelli L, Ceccarelli G, Borrazzo C, et al. Real word outcomes associated with use of raltegravir in older people living with HIV: results from the 60 months follow-up of the RAL-age cohort. Expert Rev Anti Infect Ther, 2020, 18(5): 485-492.
5. 国家癌症中心中国结直肠癌筛查与早诊早治指南制定专家组. 中国结直肠癌筛查与早诊早治指南(2020, 北京). 中华肿瘤杂志, 2021, 43(1): 16-38.
6. Benson AB, Venook AP, Al-Hawary MM, et al. NCCN guidelines insights: colon cancer, version 2. 2018. J Natl Compr Canc Netw, 2018, 16(4): 359-369.
7. Dasari A, Morris VK, Allegra CJ, et al. ctDNA applications and integration in colorectal cancer: an NCI Colon and Rectal-Anal Task Forces whitepaper. Nat Rev Clin Oncol, 2020, 17(12): 757-770.
8. Pisano M, Zorcolo L, Merli C, et al. 2017 WSES guidelines on colon and rectal cancer emergencies: obstruction and perforation. World J Emerg Surg, 2018, 13: 36.
9. Watanabe T, Muro K, Ajioka Y, et al. Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2016 for the treatment of colorectal cancer. Int J Clin Oncol, 2018, 23(1): 1-34.
10. You YN, Hardiman KM, Bafford A, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the management of rectal cancer. Dis Colon Rectum, 2020, 63(9): 1191-1222.
11. Gresham G, Cheung WY, Speers C, et al. Time to adjuvant chemotherapy and survival outcomes among patients with stage 2 to 3 rectal cancer treated with preoperative chemoradiation. Clin Colorectal Cancer, 2015, 14(1): 41-45.
12. Hawkins AT, Ford MM, Geiger TM, et al. Neoadjuvant radiation for clinical T4 colon cancer: A potential improvement to overall survival. Surgery, 2019, 165(2): 469-475.
13. Kuan FC, Lai CH, Ku HY, et al. The survival impact of delayed surgery and adjuvant chemotherapy on stage Ⅱ/Ⅲ rectal cancer with pathological complete response after neoadjuvant chemoradiation. Int J Cancer, 2017, 140(7): 1662-1669.
14. Nachiappan S, Askari A, Mamidanna R, et al. The impact of adjuvant chemotherapy timing on overall survival following colorectal cancer resection. Eur J Surg Oncol, 2015, 41(12): 1636-1644.
15. 刘勇, 汪晓东, 由屹先, 等. 数据库研究第九部分: 结直肠癌的新辅助治疗. 中国普外基础与临床杂志, 2021, 28(5): 657-663.
16. 汪晓东, 刘健博, 何欣林, 等. 数据库研究第六部分: 结直肠癌的分期策略. 中国普外基础与临床杂志, 2020, 27(6): 739-46.
17. 汪晓东, 孟鑫宇, 刘健博, 等. 数据库研究第八部分: 结直肠癌术后风险与并发症. 中国普外基础与临床杂志, 2021, 28(3): 369-375.
18. Hasan S, Renz P, Wegner RE, et al. Microsatellite instability (MSI) as an independent predictor of pathologic complete response (PCR) in locally advanced rectal cancer: A National Cancer Database (NCDB) analysis. Ann Surg, 2020, 271(4): 716-723.
19. Le DT, Durham JN, Smith KN, et al. Mismatch repair deficiency predicts response of solid tumors to PD-1 blockade. Science, 2017, 357(6349): 409-413.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Database research part Ⅹ: feature analysis of adjuvant treatment of colorectal cancer

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