LIAO Weihao 1,2 , LI Hao 1,2 , WU Guiyi 1,2 , ZHOU Fanlin 1,2 , WANG Xiaodong 1 , LI Li 3
  • 1. Department of General Surgery, Division of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
  • 2. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;
  • 3. Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
WANG Xiaodong, Email: wangxiaodong@wchscu.cn
colorectal cancer; occupation; pathological TNM stage; Database from Colorectal Cancer; overall survival; disease-specific survival
10.7507/1007-9424.202403013
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Objective To understand the relation between the occupation and long-term prognosis of the patients with colorectal cancer (CRC) based on the Database from Colorectal Cancer (DACCA). Methods The selected updated DACCA database as of June 29, 2022 was used for this study. The demographic variables selected in this study included the gender, age, and occupation; The oncology variables included pathological TNM (pTNM) stage, tumor location, tumor pathology, and differentiation; And the outcome variable was survival status, including overall survival rate and disease-specific survival rate. The included patients were divided into an intellectual occupations group (intellectual group) and manual occupations group (manual group) referring to relevant regulatory documents in China. The survival status of the intellectual group and the manual group was compared, and then which were stratified comparison by pTNM stage. Results A total of 1 974 pieces of patients data were included from the DACCA database according to the selection criteria, 349 of whom in the intellectual group and 1 625 of whom in the manual group. The intellectual group had better 5-year cumulative overall survival rate (92.1% vs. 84.5%, P<0.001) and disease-specific survival rate (92.1% vs. 85.8%, P=0.002), as well as better 10-year cumulative overall survival rate (72.4% vs. 55.2%, P<0.001) and disease-specific survival rate (75.4% vs. 59.1%, P<0.001) compared to the manual group. The stratified analysis by pTNM staging found that, for the patients with pTNM stage Ⅲ, the 5- and 10-year cumulative overall survival rate of the intellectual group were better than the manual group (94.0% vs. 82.3%, P<0.001; 67.1% vs. 43.7%, P=0.014), while the 5- and 10-year cumulative disease-specific survival rate were the same as the overall survival rate (94.0% vs. 83.5%, P=0.001; 69.5% vs. 47.9%, P=0.026). Furthermore for the the patients with pTNM stage Ⅱ, it was found that the the 10-year cumulative disease-specific survival rate of the intellectual group was better than the manual group (93.5% vs. 78.7%, P=0.009). Conclusions From the analysis results of this study, occupation might be related to long-term prognosis in colorectal cancer patients. A general trend is that the long-term prognosis of patients with intellectual occupations might be better than that of patients with manual occupations, and this difference might be relatively significant in the patients with pTNM Ⅱ and pTNM Ⅱ stages, but it is need to be autious and objective.