SUMSearch and TRIP database are meta search engines for searching clinical evidence. This article introduces major contents and search methods of the SUMSearch and TRIP database, so as to provide quick search resources and technical help for evidence-based practice.
ObjectiveTo explain details of colorectal cancer surgery in detail as well as their tags and structures of Database from Colorectal Cancer (DACCA) in the West China Hospital.MethodThe article was described in words.ResultsThe details of colorectal cancer surgery module included procedure of anastomosis, shape of anastomosis, type of staple, enhanced suture for anastomosis, stuffing, drainage, coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, drug implants, and nano of the DACCA in the West China Hospital were defined. The data labels corresponding to each item in the database and the structured ways needed for the big data application stage in detail were explained. And the error correction notes for all classification items were described.ConclusionsThrough the detailed description of the details of colorectal cancer surgery of DACCA in West China Hospital, it provides the standard and basis for the clinical application of DACCA in the future, and provides reference for other peers who wish to build a colorectal cancer database.
ObjectivesTo compare the survival outcomes between hepatocellular carcinoma and hepatic angiosarcoma, and to develop and validate a nomogram predicting the outcome of hepatic angiosarcoma.MethodsThe Surveillance, Epidemiology and End Results (SEER) database was electronically searched to collect the data of hepatic angiosarcoma patients and hepatocellular carcinoma patients from 2004 to 2016. Propensity score matching (PSM) was used to match the two groups by the ratio of 1:3. Cox regression analysis was used to compare the survival outcomes between hepatic angiosarcoma and HCC. In the angiosarcoma group, population was divided into training set and validation set by 6:4. Nomograms were built for the prediction of half- and one- year survival, and validated by concordance index (C-index) and calibration plots.ResultsA total of 210 histologically confirmed hepatic angiosarcoma patients and 630 hepatocellular carcinoma patients were included. The overall survival of HCC was significantly longer than angiosarcoma (3-year survival: 18.4% vs. 6.7%, median survival: 5 months vs. 1 month, P<0.001), and the nomogram achieved good accuracy with an internal C-index of 0.751 and an external C-index of 0.737.ConclusionsThe overall survival of HCC is significantly longer than angiosarcoma. The proposed nomograms can assist to predict survival probability in patients with hepatic angiosarcoma. Due to limitation of the data of included patients, more high-quality studies are required to verify above conclusions.
Objective To analyze the relationship between age and tumor characteristics of colorectal patients served by West China Hospital of Sichuan University as a regional center in the current version of Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on January 5, 2022. All data items included age, precancerous lesions, family history of cancer, tumor site, distance of tumor from dentate line, tumor morphology, location, pathological properties of tumor, differentiation, and preoperative TNM stage. The patients were divided into three groups according to the age segment proposed by the United Nations World Health Organization (WHO): 35 years old and below (including infant, infant, child, teenager and youth, young group), 35 to 59 years old (middle-aged group), and 60 years old and above (elderly group). Results After scanning, 7 856 data rows were analyzed. ① There was significant difference in the composition ratio of precancerous lesions with or without among different age groups (χ2=6.219, P=0.045), and the constituent ratio of various precancerous lesions in different age groups was also statistically significant (χ2=51.698, P<0.001). ② There was significant difference in the composition ratio of family history of cancer with or without among different age groups (χ2=50.212, P<0.001), and there was significant difference in the composition ratio of different tumor history among different age groups (χ2=9.880, P=0.027), and there was significant difference in the constituent ratio of various tumor history among relatives in different age groups (χ2=16.138, P=0.003). ③ There were significant differences in the number of primary cancers among different age groups (χ2=12.973, P=0.036). In all patients with single primary rectal cancer, the constituent ratio of different rectal tumor sites among different age groups was statistically significant (χ2=43.817, P<0.001), and in all patients with single primary colon cancer, there was significant difference in the composition ratio of different colon tumor sites between different age groups (χ2=86.704, P<0.001). ④ The distance of tumor from dentate line was statistically significant in different age groups (H=28.589, P<0.001). ⑤ There was no significant difference in the composition ratio of tumor location among different age groups (χ2=14.795, P=0.140). ⑥ There was significant difference in the composition ratio of pathological properties of tumor among different age groups (χ2=121.387, P<0.001). ⑦ The proportion of tumor morphology was significantly different among different age groups (χ2=89.719, P<0.001). ⑧ There were significant differences in differentiation degree of tumor among different age groups (H=43.544, P<0.001). ⑨ There was statistically significant difference in preoperative TNM stage of colorectal cancer among different age groups (H=7.547, P=0.023). Conclusions Preoperative tumor characteristics of colorectal cancer patients are associated with age at diagnosis. Most young colorectal cancer patients do not have precancerous lesions, and once precancerous lesions are present, familial adenomatous polyposis is more common. Younger patients with colorectal cancer also have a higher percentage of relatives with a family history of cancer with colorectal cancer. From the perspective of tumor location, the proportion of single primary cancer in young colorectal cancer is higher than that in middle-aged and elderly patients. Younger patients with rectal cancer have a lower distance of tumor from dentate line, a higher proportion of low differentiated malignant tumors, and a relatively later neoplasm staging.
ObjectiveTo analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on July 16th, 2020. The data items included operative duration, anatomy (anatomical difficulty), pelvis (pelvic stenosis), obesity (abdominal obesity), adhesion (adhesion in surgical area), mesentery (abnormal mesenteric status), hypertrophy (tissue hypertrophy or organ hypertrophy), intestinal quality, death (risk of death), injury (risk of tissue injury), recurrence (tumor recurrence), metastasis (tumor metastasis), anastomotic leakage (risk of anastomotic leakage), difficulty of operation, prognosis, quality of operation. The selected data items were statistically analyzed.ResultsThetotal number of medical records (data rows) that met the criteria was 6 116. Spearman correlation text showed a negative correlation between operative duration and years (rs=–0.433, P<0.001). In anatomy, pelvis, obesity, adhesion, mesentery, and hypertrophy, the most cases were “normal or basically normal”, and the percentages were 32.55%, 44.52%, 48.68%, 55.79%, 53.36%, and 57.72%, respectively. In quality of intestinal, the highest proportion was “bad” (43.25%). In risk of death, risk of tissue injury, and tumor recurrence, the most cases were “very small”, and the percentages were 69.00%, 94.41%, and 68.21%, respectively. In tumor metastasis, risk of anastomotic leakage, difficulty of operation, prognosis, and quality of operation, the highest proportion were “small” (48.58%), “average” (49.25%), “average” (32.96%), “uncertain” (45.65%), and “very good” (39.85%).ConclusionsIn the DACCA, the intestinal quality is characteristic of difficulty in operation, and in the evaluation of operation quality, the judgment of anastomotic leakage deserves much more attention. However, the relationship between the difficulty of operation and postoperative effects, and the relationship between the quality of operation and the prognosis still need to be further studied.
ObjectiveTo analyze the characteristics of adjuvant treatment of colorectal cancer in the Database from Colorectal Cancer (DACCA).MethodsThe 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.ResultsA 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. ConclusionBy expounding the characteristics of the current adjuvant treatment of colorectal cancer in DACCA, it provides a reference for the adjuvant treatment of colorectal cancer.
ObjectiveTo analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on April 16th, 2020. The data items included timing of operation, types of operative procedure, radical resection level of operation, patient’s wish of anus-reserving, types of stomy, date of stoma closure, surgical approaches, extended resection, and type of intersphincteric resection (ISR). The data item interval of stoma closure was added, and the selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 11 757, including 2 729 valid data on the timing of operation (23.2%), 11 389 valid data on the types of operative procedure (96.9%), 4 255 valid data on the radical resection level of operation (36.2%), 3 803 valid data on patient’s wish of anus-reserving (32.3%), 4 377 valid data on types of stomy (37.2%), 989 valid data on date of stoma closure (8.4%), 4 418 valid data on surgical approaches (37.6%), 3 941 valid data on extended resection (33.5%), and 1 156 valid data on type of ISR (9.8%). In the timing of operation, the most cases were performed immediately after discovery or neoadjuvant completion (915, 33.5%). In types of operative procedure, ultra low anterior resection (ULAR), right hemicolectomy (RHC), and low anterior resection (LAR) were the most, including 1 986 (17.4%), 1 412 (12.4%), and 1 041 (9.1%) lines. Respectively in the colon and rectal cancer surgery, the proportion of RHC (50.0%) and ULAR (26.0%) was the highest, with 172 (26.1%) and 815 (27.9%) extended resection. In ISR surgery the majority was ISR-2 (741, 64.1%). In radical resection level of operation, the number of R0 was the largest with 2 575 (60.5%) lines. In patient’s wish of anus-reserving, positive and rational were the most with 1 811 (47.6%) and 1 440 (37.9%) lines, respectively. And in types of stomy, there were 2 628 lines (60.0%) without stoma and 1 749 cases (40.0%) with stoma, among which the most lines were right lower ileum stoma (612, 35.0%). The minimum value, maximum value, and median value of interval of stoma closure were 0 d, 2 678 d and 112 d. The linear regression prediction of date of stoma closure by year was \begin{document}${\hat {y}} $\end{document}=9.234 3x+22.394 (R2=0.2928, P=0.07). In the surgical approaches, the majority was standard with 3 182 (72.0%) lines.ConclusionsIn the DACCA, rectal cancer surgery is still the majority, and ULAR is the most type. The application of extended resection in both colon and rectal cancer has important significance. The data related to stoma are diversified and need to be further studied.
ObjectiveBased on the current version of Database from Colorectal Cancer (DACCA), we aimed to analyze the preoperative specialized examination and evaluation of colorectal cancer.MethodsThe DACCA version selected for this data analysis was updated on July 25, 2019. The data items included: combined preoperative stage, integrating degree of combined preoperative stage, preoperative diagnostic intensity, accuracy of colonoscopy, tumorous type by biopsy, tumor differentiation by biopsy, completion of chest CT, CT stage, accuracy of CT stage, outcome of transrectal ultrasound, outcome of liver ultrasound, MRI stage, accuracy of MRI stage, outcome of PET-CT, outcome of bone scanning, diagnostic way at first visit, misdiagnosis and mistreatment. Characteristic analysis was performed on each selected data item.ResultsA total of 4 484 admitted data were filtered from the DACCA database. The effective data of accuracy of preoperative CT examination, evaluation of preoperative CT staging, preoperative MRI accuracy, preoperative MRI evaluation stage, the accuracy of preoperative transrectal ultrasound, preoperative liver ultrasound accuracy, the accuracy of preoperative bone scan, preoperative PET-CT accuracy, completion of colonoscopy, preoperative colonoscopy biopsy pathology type, strength of diagnosis, integrating degree of total preoperative staging, preoperative staging and pathological staging, factors of the first diagnosis, misdiagnosis and mistreatment were 3 877 (86.5%), 3 166 (70.6%), 3 480 (77.6%), 286 (6.4%), 3 607 (80.4%), 2 736 (61.0%), 3 570 (79.6%), 3 490 (77.8%), 3 847 (85.8%), 3 636 (81.1%), 3 981 (88.8%), 2 346 (52.3%), 2 209 (49.3%), 3 466 (77.3%), and 3 411 (76.1%), respectively. Among the preoperative CT stages, phase Ⅳ had the highest accuracy (86.6%), phase Ⅰ had the highest rate of underestimation (30.4%), and phase Ⅲ had the highest rate of overestimation (21.8%). Preoperative CT accuracy, excluding errors caused by too few data rows, was 66.8%–83.7% in other years. Among the preoperative MRI stages, stage Ⅳ showed the highest accuracy (89.1%), stage Ⅰ showed the highest rate of underestimation (33.3%), and stage Ⅲ showed the highest rate of overestimation (13.3%). Preoperative MRI evaluation accuracy gradually increased from 2016 to 2019. The accuracy of transrectal ultrasound, liver ultrasound, bone scan, and PET-CT were 287 (76.7%), 145 (99.3%), 301 (98.7%), and 15 (93.8%), respectively. The most pathological type under colonoscopy was adenocarcinoma, accounting for 82.2%. The lowest was stromal tumor and lymphoma, each below 0.1%. The diagnostic efficiency were 3 445 (86.5%) with grade A, 316 (7.9%) with grade B, and 220 (5.5%) with grade C. In the preoperative total staging, 109 data rows (4.9%) were appeared as stage Ⅰ, 615 (27.5%) as stage Ⅱ, 1 263 (56.6%) as stage Ⅲ, and 245 (11.0%) as stage Ⅳ. The preoperative total staging integrating degree in stage Ⅳ was the highest (98.7%), while the underestimate rate in stage Ⅱ was the highest (28.3%), and the overestimate rate in stage Ⅲ was the highest (20.6%). From 2008 to 2019, the integrating degree between preoperative comprehensive staging and final pathology staging ranged from 70.8% to 87.7%. Among the factors of the first diagnosis, digital examination was found the frequently (64.0%), followed by symptoms such as bleeding and obstruction (28.2%). Considering family history, the proportion of patients with colorectal cancer was the least (less than 0.1%). There were 442 cases (13.0%) of misdiagnosis and mistreatment behaviors, among which 207 cases (46.8%) were misdiagnosed as hemorrhoids.ConclusionsTo significantly improve the long-term survival rate of colorectal cancer patients requires preoperative imaging diagnosis efficiency and multi-factor evaluation staging to break through the limitation of development, so as to optimize the choice of treatment plan, increasing the prevalence of early screening for colorectal cancer, and reducing the rate of misdiagnosis and mistreatment at the first visit of colorectal cancer.
Objective To establish a prediction model for the 1-, 3-, and 5-year survival rates in patients with gastric cancer liver metastases (GCLM) by analyzing prognostic factors based on the Surveillance, Epidemiology, and End Results (SEER) database. Methods Clinical and pathological data from 591 patients diagnosed with GCLM between 2010 and 2015 were obtained from the SEER database. The population was randomly divided into a training cohort and an internal validation cohort at a 7 to 3 ratio. Independent predictors of GCLM were analyzed using univariate and multifactorial Cox regression. Consequently, nomograms were constructed. The model's accuracy was verified by calibration curve, ROC curve, and the C-index, and the clinical utility of the model was analyzed through decision curve analysis. Results Tumor differentiation grade, surgical status, and chemotherapy were significantly associated with the prognosis of GCLM patients, and these three factors were included in constructing the prognostic model and plotting the nomogram. The C-index was 0.706 (95%CI 0.677 to 0.735) and 0.749 (95%CI 0.710 to 0.788) for the training set and the internal validation cohort, respectively. The results of the ROC curve analysis indicated that the area under the curve (AUC) was over 0.7 at 1, 3, and 5 years for both the training and validation cohorts. Conclusion The prediction model of the GCLM is developed based on the 3 factors, i.e., tumor differentiation grade, surgery, and chemotherapy, and shows good prediction accuracy and thus may promote clinical decision making and individualized treatment of GCLM patients.
ObjectiveTo elaborate constitute, definition, and interpretation of tumor characteristics module of colorectal cancer in the Database from Colorectal Cancer (DACCA) in the West China Hospital.MethodThe article was described in the words.ResultsThe tumor features module of colorectal cancer in the DACCA included the precancerous lesion, cancer family, location of tumor, distance to the dentate line, morphology of tumor, size, position, happening and origination, differentiation, pathology of tumor, Ki-67 protein, obstruction, intussusception, perforation, pain, edema, and hemorrhage. The exact definitions of morphology of tumor, size, position, differentiation, pathology of tumor, Ki-67 protein and complication (included obstruction, intussusception, perforation, pain, edema, and hemorrhage), tag and structure, corrective precautions and update of these columns, and how to use these tumor characteristics in the DACCA when analysis was carried out were described in detail.ConclusionThrough detailed description and specification of current tumor characteristics module of colorectal cancer in DACCA in West China Hospital, it can provide a reference for standardized treatment of colorectal cancer and also provide experiences for the peers who wish to build a colorectal cancer database.
