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.	劉勇, 汪曉東, 由屹先, 等. 數據庫研究第九部分: 結直腸癌的新輔助治療. 中國普外基礎與臨床雜志, 2021, 28(5): 657-663.
16.	汪曉東, 劉健博, 何欣林, 等. 數據庫研究第六部分: 結直腸癌的分期策略. 中國普外基礎與臨床雜志, 2020, 27(6): 739-46.
17.	汪曉東, 孟鑫宇, 劉健博, 等. 數據庫研究第八部分: 結直腸癌術后風險與并發癥. 中國普外基礎與臨床雜志, 2021, 28(3): 369-375.
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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. 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.
2. 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.
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. 國家癌癥中心中國結直腸癌篩查與早診早治指南制定專家組. 中國結直腸癌篩查與早診早治指南(2020, 北京). 中華腫瘤雜志, 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. 劉勇, 汪曉東, 由屹先, 等. 數據庫研究第九部分: 結直腸癌的新輔助治療. 中國普外基礎與臨床雜志, 2021, 28(5): 657-663.
16. 汪曉東, 劉健博, 何欣林, 等. 數據庫研究第六部分: 結直腸癌的分期策略. 中國普外基礎與臨床雜志, 2020, 27(6): 739-46.
17. 汪曉東, 孟鑫宇, 劉健博, 等. 數據庫研究第八部分: 結直腸癌術后風險與并發癥. 中國普外基礎與臨床雜志, 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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