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 analyze the details and efficacy of neoadjuvant therapy of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe 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.ResultsThe 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.ConclusionsThe 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.
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.
ObjectivesTo summarize and compare the operative mechanisms of the most representative comprehensive clinical practice guideline (CPG) databases worldwide, so as to provide references for establishing and managing Chinese CPG database.MethodsCPG databases were collected worldwide by discussing with experts in the guideline and database fields. Studies on guideline databases were searched in PubMed and CNKI to further collect CPG databases mentioned in these studies. Representative comprehensive guideline databases were finally selected by consulting relevant guideline experts. The institutions’ names of establishing and managing CPG databases, funding sources, human resources, aims, quality control measures (including CPG inclusion and updating criteria) were extracted and summarized. Databases were divided into government-led, society-led, and enterprise-led models. A descriptive analysis was conducted.ResultsThere were four government-led databases, four society-led databases and merely one enterprise-led database. The institutions of establishing CPG databases were same as the institutions of managing databases in the seven databases. All CPG databases had set up offices, seven of which were located in the capital. Most databases’ funds came from the government. Four databases implemented board management. According to the division of functions, members involved in establishing and managing CPG databases mainly included leaders, expert teams, managerial personnel, secretaries, web developers, and patient representatives. Criteria for inclusion of CPG were relevant to the purpose of establishing databases. Most databases required guidelines that had be updated within three to five years.ConclusionsThis study provides comprehensive information on operative mechanism of different CPG databases which can assist guideline database builders to optimize their operative mechanism.
objective To analyze the impact of body mass index (BMI) on medical and surgical complications of colorectal cancer patients served by West China Hospital, based on the current version of Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on September 27, 2021. The data included BMI, surgical complications, liver nodules, liver function, renal nodules, renal function, operation history, medical complications, diabetes, hypertension, pneumonia, pulmonary nodules, pulmonary function, heart disease, thrombosis, and cardiac function. Results After scanning, 5 305 data rows were included. BMI was divided by Chinese four classification methods. The analysis results showed that in terms of surgical complications, obese patients were more likely to be complicated with surgical complications of digestive system (χ2= 43.883, P<0.001) and reproductive system (χ2=13.139, P=0.004). Lean patients were more likely to have surgical complications of urinary system (χ2=223.415, P<0.001), and obese patients had liver function (H=61.521, P<0.001) and renal function (H=9.994, P=0.019) might be even worse. In terms of operation history, BMI in colorectal cancer patients had nothing to do with the number of times of operation (H=6.262, P=0.100), and operation history of each system or department (P>0.05). Regarding to medical complications, with the increase of BMI, the risk of colorectal cancer patients with diabetes mellitus (χ2=118.597, P<0.001), or hypertension (χ2= 163.334, P< 0.001) increased. Patients with low BMI were more likely to have pneumonia (H=7.899, P= 0.048) and worse pulmonary function (H=40.673, P<0.001). Conclusions The analysis results of DACCA database show that BMI is not related to the occurrence of any special surgical history included in the research. Because the internal and external complications of patients are closely related to the treatment plan and prognosis, we should pay more attention to the obese patients in the process of clinical treatment, and they are more likely to have multisystemic abnormalities and various abnormal indicators than other patients. For thin patients, we should pay more attention to their lung function and inflammatory lesions, so as to improve the clinical therapeutic effect.
Objective To analyze the impact of body mass index (BMI) on hospitalization process of colorectal cancer patients served by West China Hospital, based on the current version of Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on April 30, 2021. All data items included BMI, visiting data, admission date, operation date, discharging date, pre-hospitalization time, pre-operation time, post-operation time, total hospital stay, and management process. Results After scanning, 5 564 data rows were analyzed, from 2007 to 2021. The range of BMI was 11.02–39.67 kg/m2, the average of BMI was (22.86±3.28) kg/m2, and the BMI increased with year \begin{document}$ (\widehat{y} $\end{document}=0.058x–94.23, R2=0.005, P<0.001). The results of BMI characteristic analysis showed that BMI was not statistically significant related to the pre-hospitalization time, the pre-operation time, and the total length of hospital stay (P>0.05). However, the BMI would affect patients’ postoperative hospital stay and process management (P<0.05). Among them,obese group had shorter postoperative hospital stay than other groups (P=0.014). Additionally, there was significant difference in management process among colorectal cancer patients with different BMI (χ2=26.84, P=0.001). In process management, “ERAS” management accounted for the largest proportion (66.37%), but for each process management category, lean people were more likely to choose “enhanced” management process (11.08%), and obese people were more likely to choose “individual” process management (6.05%). Conclusions The analysis results reflect that the BMI of colorectal cancer patients have an increasing trend year by year. BMI has no clear correlation with patients’ waiting time before admission, pre-operative time, and total hospital stay. Therefore, from the perspective of hospitalization management, the hospitalization operation ability of patients with colorectal cancer was not affected by BMI. The BMI of patients will affect the postoperative hospital stay and process management. The obese people have a shorter postoperative hospital stay and are more likely to choose non-process management.
Objective To evaluate the prognostic value of surgical treatment in gallbladder squamous cell carcinoma (GSCC) by using real-world data with a large sample in the Surveillance, Epidemiology and End Results (SEER) database. Methods The clinical data of patients with pathologically diagnosed GSCC from 2000 to 2019 were extracted from the SEER database. According to the inclusion and exclusion criteria, a total of 257 patients were included after strict screening. The patients were divided into operation group and non-operation group according to whether they underwent surgery. The cancer-specific survival (CSS) and the overall survival (OS) between the two groups were compared, and the influencing factors for the CSS and the OS were analyzed by using Cox proportional hazard model. Results Of 257 patients, 127 (49.4%) were in the operation group, and 130 (50.6%) in the non-operation group. The average follow-up ranged from 0 to 220 months, with the median follow-up time of 3 months. Of the 127 patients in the operation group, 105 died (82.7%), including 88 tumor-related deaths (69.3%). Of the 130 patients in the non-operation group, 124 died (95.4%), including 115 tumor-related deaths (88.5%). The median survival time for OS in the operation group and the non-operation group were 6 months and 3 months, respectively, and that for CSS were 7 months and 3 months, respectively. The estimated 1-year OS of the operation group and the non-operation group were 30.1% and 4.6% respectively; the estimated 1-year CSS were 35.1% and 5.8%, respectively. There were significant differences between the two groups on OS and CSS (χ2=41.400, P<0.001; χ2=42.750, P<0.001). That the OS [HR=0.44, 95%CI (0.25, 0.77), P=0.004] and the CSS [HR=0.46, 95%CI (0.25, 0.84), P=0.011] in GSCC patients were significantly improved by surgical treatment, showed by the results of multivariate prognostic analysis via Cox proportional hazard mode. Conclusions Surgical treatment was an independent factor affecting the prognosis of GSCC, and it could improve the OS and the CSS. As for the modus operandi, R0 resection should be recommended.
ObjectiveTo analyze the tumor characteristics of colorectal cancer in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version was the updated version on April 16, 2020. The data items including: procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, drainage, coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants were analyzed for the characteristics of each selected data item.ResultsA total of 6 338 analyzable data rows were obtained by screening the DACCA database. Among the 6 338 pieces of data, the most common one was the double staple technique (58.1%), end-to-end anastomosis (69.4%), one-total-circle of enhancement (33.2%), and without stuffing (54.1%) in the items of procedure of anastomosis, shape of anastomosis, enhanced suture for anastomosis, stuffing, respectively; the ratio with drainage was higher (79.2%) in the term of drainage, the drainage time was (3.74±2.89) d and median drainage time was 3.00 d; the ratio with covering part of major omentum, without anti-adhesion material, with unilateral partial closure, without contaminate, and without drug implants were more higher, which was 41.1%, 79.8%, 58.7%, 73.9%, and 53.9% in the items of coverage of major omentum, anti-adhesion material, reconstruction of pelvic peritoneum, contaminate, and drug implants, respectively.ConclusionIt might better explain the outcome of surgery associated with intraoperative operation by studying the features of surgery of DACCA and guide the operation in the future for better outcomes.
ObjectiveTo detect expression of DTX2 molecule in colorectal cancer (CRC) tissues and investigate its clinical significances.MethodsOncomine and GEPIA databases were used to analyze the expression of DTX2 gene in CRC tissues and normal colorectal tissues, and online data of human protein atlas (HPA) was used to analyze the relationship between DTX2 protein expression and survival prognosis of patients with CRC. The expressions of DTX2 mRNA and protein were detected in the 55 cases of CRC tissues and corresponding paracancerous normal (PN) tissues by using qRT-PCR, Western blot, and immunohistochemistry methods, respectively. The correlations between the expression of DTX2 and the clinicopathologic characteristics were analyzed.Results① The data from Oncomine and GEPIA databases showed that the expression levels of DTX2 mRNA in the CRC tissues were significantly higher than those in the normal colorectal tissues (P<0.05); HPA online data analysis showed that the overall survival of CRC patients with low expression of DTX2 was better than that with high expression of DTX2 (P=0.009 8). ② The results of qRT-PCR and Western blot showed that the expression levels of DTX2 mRNA and protein in the CRC tissues were higher than those in the PN tissues (t=0.722, P<0.001; t=1.314, P<0.001); The results of immunohistochemical staining showed that the positive rate of DTX2 protein expression in the CRC tissues was higher than that in the PN tissues (χ2=0.899, P<0.001). The positive rate of DTX2 protein expression and the expression levels of DTX2 mRNA and protein were related to the depth of tumor invasion, lymph node metastasis, and TNM stage of CRC patients, that was, the deeper depth of tumor invasion, the more lymph node metastasis, and the later TNM stage, the higher positive rate of DTX2 protein expression, the higher expression levels of DTX2 mRNA and protein (P<0.05).ConclusionsDTX2 protein may be a novel biomarker for estimating progression of CRC. However, prognosis evaluation of DTX2 protein on CRC needs further clinical research.
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.
