Database research part <b>Ⅸ</b>: neoadjuvant therapy of colorectal cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yong ¹ , WANG Xiaodong ¹ , YOU Yixian ^1,2 , YU Kexin ^1,2 ,  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 Medicine, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

LI Li, Email: drlili116@126.com

Keywords：

colorectal cancer; database; big data; neoadjuvant therapy; medical quality

DOI：

10.7507/1007-9424.202103125

Video：

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Objective To analyze the details and efficacy of neoadjuvant therapy of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).Methods The DACCA version selected for this data analysis was the updated version on July 28th, 2020. The data items included “planned strategy of neoadjuvant therapy” “compliance of neoadjuvant therapy”, and “cycles of neoadjuvant therapy”. Item of “planned strategy of neoadjuvant therapy” included “accuracy of neoadjuvant therapy” and “once included in researches”. Item of “the intensity of neoadjuvant therapy” included “chemotherapy” “cycles of neoadjuvant therapy” “targeted drugs”, and “neoadjuvant radiotherapy”. Item of “effect of neoadjuvant therapy” included CEA value of “pre-neoadjuvant therapy” and “post-neoadjuvant therapy”“variation of tumor markers” “variation of symptom” “variation of gross” “variation of radiography”, and tumor regression grade (TRG). The selected data items were statistically analyzed.Results The total number of medical records (data rows) that met the criteria was 7 513, including 2 539 (33.8%) valid data on the “accuracy of neoadjuvant therapy”, 498 (6.6%) valid data on “once included in researches”, 637 (8.5%) valid data on the “compliance of neoadjuvant therapy”, 2 077 (27.6%) valid data on “neoadjuvant chemotherapy”, 614 (8.2%) valid data on “cycles of neoadjuvant therapy”, 455 (6.1%) valid data on “targeted drugs”, 135 (1.8%) valid data on “neoadjuvant radiotherapy”, 5 022 (66.8%) valid data on “pre-neoadjuvant therapy CEA value”, 818 (10.9%) valid data on “post-neoadjuvant therapy CEA value ”, 614 (8.2%) valid data on “variation of tumor marker”, 464 (6.2%) valid data on “variation of symptom”, 478 (6.4%) valid data on “variation of gross”, 492 (6.5%) valid data on “variation of radiography”, and 459 (6.1%) valid data on TRG. During the correlation analysis, it appeared that “variation of tumor marker” and “variation of gross” (χ²=6.26, P=0.02), “variation of symptom” and “variation of gross”, “radiography” and TRG (χ²=53.71, P<0.01; χ²=38.41, P<0.01; χ²=8.68, P<0.01), “variation of gross” and “variation of radiography”, and TRG (χ²=44.41, P<0.01; χ²=100.37, P<0.01), “variation of radiography” and TRG (χ²=31.52, P<0.01) were related with each other.Conclusions The protocol choosing of neoadjuvant therapy has a room for further research and DACCA can provide data support for those who is willing to perform neoadjuvant therapy. The efficacy indicators of neoadjuvant therapy have association with each other, the better understand of it will provide more valuable information for the establishment of therapeutic prediction model.

Citation： LIU Yong, WANG Xiaodong, YOU Yixian, YU Kexin, LI Li, ZHOU Zongguang. Database research part Ⅸ: neoadjuvant therapy of colorectal cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(5): 657-663. doi: 10.7507/1007-9424.202103125 Copy

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10.	Deng Y, Chi P, Lan P, et al. Modified FOLFOX6 with or without radiation versus fluorouracil and leucovorin with radiation in neoadjuvant treatment of locally advanced rectal cancer: initial results of the Chinese FOWARC multicenter, open-label, randomized three-arm phase Ⅲ trial. J Clin Oncol, 2016, 34(27): 3300-3307.
11.	Fokas E, Allg?uer M, Polat B, et al. Randomized phase Ⅱ trial of chemoradiotherapy plus induction or consolidation chemotherapy as total neoadjuvant therapy for locally advanced rectal cancer: CAO/ARO/AIO-12. J Clin Oncol, 2019, 37(34): 3212-3222.
12.	Dong Y, Liu J, He X, et al. Can clinical-CR predict pathologic-CR after neoadjuvant chemotherapy? A primary study on relationship between clinical factors and PCR. Dis Colon Rectum, 2019, 62(6): e300.
13.	Hu H, Huang J, Lan P, et al. CEA clearance pattern as a predictor of tumor response to neoadjuvant treatment in rectal cancer: a post-hoc analysis of FOWARC trial. BMC Cancer, 2018, 18(1): 1145.
14.	Colloca G, Venturino A, Vitucci P. Pre-treatment carcinoembryonic antigen and outcome of patients with rectal cancer receiving neo-adjuvant chemo-radiation and surgical resection: a systematic review and meta-analysis. Med Oncol, 2017, 34(10): 177.
15.	Zhang M, Li J, Ma X, et al. The value of magnetic resonance imaging to diagnose pathological complete response of rectal cancer after therapy: A protocol for meta-analysis. Medicine (Baltimore), 2018, 97(43): e12901.
16.	鄒雨恒, 劉健博, 汪曉東, 等. 直腸癌新輔助治療后病理完全緩解的預測進展. 中華結直腸疾病電子雜志, 2020, 9(5): 440-446.

1. 汪曉東, 李立. 真實場景與大數據下的整體微創理念, 大幅提高結直腸癌遠期生存率. 中國普外基礎與臨床雜志, 2019, 26(1): 92-95.
2. 劉健博, 由屹先, 鄒雨恒, 等. 數據庫輔助研究: 結直腸癌新輔助治療的應用—基于DACCA的華西真實世界數據報道. 中國普外基礎與臨床雜志, 2019, 26(12): 1467-1475.
3. Qiu B, Ding PR, Cai L, et al. Outcomes of preoperative chemoradiotherapy followed by surgery in patients with unresectable locally advanced sigmoid colon cancer. Chin J Cancer, 2016, 35(1): 65.
4. Benson AB, Venook AP, Al-Hawary MM, et al. Rectal Cancer, Version 2. 2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2018, 16(7): 874-901.
5. Benson AB, Venook AP, Al-Hawary MM, et al. Colon Cancer, Version 2. 2021, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2021, 19(3): 329-359.
6. 中華人民共和國國家衛生健康委員會. 中國結直腸癌診療規范 (2020年版). 中華外科雜志, 2020, 58(8): 561-585.
7. 呂炘沂, 劉健博, 謝欣然, 等. 基于傾向評分匹配的患者依從性對結直腸癌新輔助治療療效的影響. 實用醫學雜志, 2020, 36(22): 3104-3109.
8. Jia AY, Narang A, Safar B, et al. Sequential short-course radiation therapy and chemotherapy in the neoadjuvant treatment of rectal adenocarcinoma. Radiat Oncol, 2019, 14(1): 147.
9. Teo MTW, McParland L, Appelt AL, et al. Phase 2 neoadjuvant treatment intensification trials in rectal cancer: A systematic review. Int J Radiat Oncol Biol Phys, 2018, 100(1): 146-158.
10. Deng Y, Chi P, Lan P, et al. Modified FOLFOX6 with or without radiation versus fluorouracil and leucovorin with radiation in neoadjuvant treatment of locally advanced rectal cancer: initial results of the Chinese FOWARC multicenter, open-label, randomized three-arm phase Ⅲ trial. J Clin Oncol, 2016, 34(27): 3300-3307.
11. Fokas E, Allg?uer M, Polat B, et al. Randomized phase Ⅱ trial of chemoradiotherapy plus induction or consolidation chemotherapy as total neoadjuvant therapy for locally advanced rectal cancer: CAO/ARO/AIO-12. J Clin Oncol, 2019, 37(34): 3212-3222.
12. Dong Y, Liu J, He X, et al. Can clinical-CR predict pathologic-CR after neoadjuvant chemotherapy? A primary study on relationship between clinical factors and PCR. Dis Colon Rectum, 2019, 62(6): e300.
13. Hu H, Huang J, Lan P, et al. CEA clearance pattern as a predictor of tumor response to neoadjuvant treatment in rectal cancer: a post-hoc analysis of FOWARC trial. BMC Cancer, 2018, 18(1): 1145.
14. Colloca G, Venturino A, Vitucci P. Pre-treatment carcinoembryonic antigen and outcome of patients with rectal cancer receiving neo-adjuvant chemo-radiation and surgical resection: a systematic review and meta-analysis. Med Oncol, 2017, 34(10): 177.
15. Zhang M, Li J, Ma X, et al. The value of magnetic resonance imaging to diagnose pathological complete response of rectal cancer after therapy: A protocol for meta-analysis. Medicine (Baltimore), 2018, 97(43): e12901.
16. 鄒雨恒, 劉健博, 汪曉東, 等. 直腸癌新輔助治療后病理完全緩解的預測進展. 中華結直腸疾病電子雜志, 2020, 9(5): 440-446.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Database research part Ⅸ: neoadjuvant therapy of colorectal cancer

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