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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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, Allgäuer 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.	邹雨恒, 刘健博, 汪晓东, 等. 直肠癌新辅助治疗后病理完全缓解的预测进展. 中华结直肠疾病电子杂志, 2020, 9(5): 440-446.

1. 汪晓东, 李立. 真实场景与大数据下的整体微创理念, 大幅提高结直肠癌远期生存率. 中国普外基础与临床杂志, 2019, 26(1): 92-95.
2. 刘健博, 由屹先, 邹雨恒, 等. 数据库辅助研究: 结直肠癌新辅助治疗的应用—基于DACCA的华西真实世界数据报道. 中国普外基础与临床杂志, 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. 中华人民共和国国家卫生健康委员会. 中国结直肠癌诊疗规范 (2020年版). 中华外科杂志, 2020, 58(8): 561-585.
7. 吕炘沂, 刘健博, 谢欣然, 等. 基于倾向评分匹配的患者依从性对结直肠癌新辅助治疗疗效的影响. 实用医学杂志, 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, Allgäuer 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. 邹雨恒, 刘健博, 汪晓东, 等. 直肠癌新辅助治疗后病理完全缓解的预测进展. 中华结直肠疾病电子杂志, 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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