ObjectiveScreening the Database from Colorectal Cancer (DACCA) based on West China Hospial data by " Operation Date”, we purposed to analyze the population characteristics of colorectal cancer patients in regional medical center within recent Database Version.MethodsThe DACCA Version was updated in December 12th, 2018. Personal data (including sex, age, blood type, height, weight, and BMI), location data (including provinces, cities, and subordinate areas in Chengdu), occupation and education data, and main diagnosis data were included in the items. Characteristic analysis was performed on each selected data item.ResultsAccording to screening, 9 633 analytical data rows were obtained. Based on the database information, there were 24 consecutive years from 1995 to 2018 into every year. We set 2005 to 2006 as the time node for the database construction. The contribution to database before 2005 (including) was 1 358, while after 2005 (not including) were 8 275. The contribution rate (contribution numbers/years) after 2005 was higher than before 2005 ［1 358/11 vs. 8 275/13, 95% CI was (–625.337, –400.831), P<0.001］. According to gender distribution, total male data were 4 669, female were 3 340, non-checked were 1 624. According to age distribution, age were from 13 to 104 ［(59±13) years］. Linear prediction was used to predict the age distribution with the " year” as the time axis. The results showed the stable linear prediction (\begin{document}$\hat y$\end{document}=0.016 1x+26.54, R2=3.42×105, P=0.601 108). According to height, height were from 138 cm to 192 cm ［(161±7)cm］, linear prediction results showed that the linear variation with height changes by value (\begin{document}$\hat y$\end{document}=0.110 5 x–60.911, R2=0.002 6, P=0.000 272). According to weight, weight were from 27.5 kg to 80.5 kg ［(59.38±10.27) kg］, linear prediction results showed that the linear variation with height changes by value (\begin{document}$\hat y$\end{document}=0.296 5x–537.24, R2=0.010 625, P=2.37×1014). Available 6 884 data showed the difference between serving areas by West China Hospital and official definition of western region. A total of 9 209 data obtained by analyzing main diagnosis, showed that the main site of disease was rectum (68.64%). Sigmoid was the main location of colon cancer (68.64%), and anal-rectal cancer was main of rectal cancer (27.06%).ConclusionPopulation characteristics from DACCA database could initially reflect the trend of increasing weight and BMI of colorectal cancer patients, and also reflect the regional distribution characteristics based on geographic information. They would be the clues for further database research.
ObjectiveTo elaborate the contents and concrete concepts of preoperative specialized examination and evaluation of colorectal cancer of the Database from Colorectal Cancer (DACCA) in the West China Hospital. MethodThe article was described in the words.ResultsThe components, stage, accuracy, preoperative comprehensive evaluation, clinical factors of initial diagnosis, misdiagnosis and mistreatment of colorectal cancer in the DACCA were defined and elaborated in the detail. The data label corresponding to each item in the database and the required structured way in the application stage of large data were also described in detail, and the corrective precautions for all classified items were described.ConclusionsThrough the detailed description of the preoperative specialized examination and evaluation of colorectal cancer of DACCA in West China Hospital, it might provide the standard and basis for the clinical application of database in the future, and provide reference for other peers who wish to build a colorectal cancer database.
ObjectiveTo analyze the staging methods of colorectal cancer data in the current version of the Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was updated at April 16th, 2020. The columns included stage during surgery, comprehensive stage of clinical, pathologic and imaging (cpi comprehensive stage), TNM stage, pathologic T stage, imaging T stage, nerves involvement, pathologic anus stage, clinical anus stage, imaging anus stage, pathologic mesentery stage, clinical mesentery stage, imaging mesentery stage, pathologic N stage, imaging N stage, positive lymph nodes ratio, cancerous nodules, M stage, cancerous emboli, pathologic vessel stage, clinical vessel stage, imaging vessel stage, cancerous contamination, and high-risk factors. Extracted data were statistically analyzed.ResultsThe total number of data medical records (data rows) that met the criteria was 6 474, the valid data of TNM stage was 4 511 (69.7%), the valid data of stage during surgery was 5 684 (87.8%), and the valid data of cpi comprehensive stage was 4 045 (62.5%). 1 540 data (41.6%) were consistent with stage during surgery and TNM stage, and 2 884 data (76.7%) were consistent with cpi comprehensive stage and TNM stage. According to the data of T, N, and M stage, the proportion of patients with pathologic T4a stage was the highest (40.5%), followed by T3 stage (24.8%); the most T4a stage (31.9%) on the image, followed by T4b stage (28.7%). The pathologic N stage with lymph node metastasis was about 41.9% (N1 and N2), and the imaging N stage lymph node metastasis was about 51.4%. There were a total of 4 745 valid data in the M stage (73.3%). There were 4 313 valid data in the nerves involvement (66.7%), suspected involvement and confirmed involvement, were 691 (16.0%) and 253 (5.9%) respectively. The valid data of anal pathology, clinical, and imaging stage were 4 115 (63.6%), 599 (9.3%), and 598 (9.2%), and only 30 (0.7%), 8 (1.3%), and 13 (2.2%) on muscle involvement respectively. The valid data of pathologic, clinical, and imaging mesentery stage were 732 (11.3%), 589 (9.1%), and 592 (9.1%). There were 4 458 (68.9%) valid data of positive lymph nodes ratio, and 2 908 (44.9%) valid data of cancerous nodules. There were 4 286 valid data of cancerous emboli (66.2%). A total of 244 data (41.1%) of increased blood vessels around tumors in the imaging vessel stage, 274 data (46.4%) of that in clinical vessel stage, and only 1 063 (27.7%) of pathologic vessel stage. There were 3 865 valid data (59.7%) of the cancerous contamination, and the proportion of the third level (746/2 753, 27.1%) in the high-risk factors was the highest.ConclusionThrough detailed analysis of the DACCA database, it is hoped that a more complete and accurate evaluation system of tumor severity can be established, and high-risk factors can provide some ideas for judging prognosis.
ObjectiveTo investigate whether neoadjuvant chemotherapy alone may affect recent anal function in patients with rectal cancer.MethodsThe structured data from the December 3, 2018 version of Database from Colorectal Cancer (DACCA) of West China Hospital were extracted . The follow-up investigation was performed within 2 weeks from December 3, 2018 to December 16, 2018 by the telephone. The postoperative anal function of patients with rectal cancer was evaluated by the lower anterior resection symptom (LARS) score questionnaire.ResultsA total of 209 patients with rectal cancer treated by the total mesolectal excision in the Department of Gastrointestinal Surgery of West China Hospital were included. One hundred and thirty-six patients of them were only treated with TME, while the other 73 patients were treated by the TME and neoadjuvant chemotherapy. As for the baseline data of the 2 groups, there was no difference in the age, body mass index, gender, surgical procedure, differentiation degree or anastomotic position (P>0.050), while the pathological staging (P=0.022) and postoperative recovery time (P<0.001) had the significant differences between these 2 groups. The postoperative 1-year LARS score was not associated with the gender, age, body mass index, pathological stage, physical comorbidity, neoadjuvant chemotherapy or time of postoperative recovery (P>0.050), but which was associated with the heart disease (P=0.019) or position of anastomosis (P=0.005). Moreover, the multivariate analysis showed that the higher anastomosis position was a protective factor for the LARS after 1 year (OR=0.706, P=0.003).ConclusionsThere is no significant difference in postoperative anal function between patients with rectal cancer treated with neoadjuvant chemotherapy or not . It suggests that neoadjuvant chemotherapy has no more additional adverse effects on postoperative anal function in patients either.