Association between occupational type of patients with colorectal cancer and decision making or curative effect of neoadjuvant therapy: a real-world study based on DACCA_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIU Yuqing ¹ , LI Dingling ² , DU Zekun ² ,  WANG Xiaodong ¹ , LI Li ³

1. Division of Gastrointestinal Surgery, Department of General 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;

Corresponding author：

WANG Xiaodong, Email: wangxiaodong@wchscu.cn

Keywords：

colorectal cancer; occupation; neoadjuvant therapy; Database from Colorectal Cancer

DOI：

10.7507/1007-9424.202405100

Video：

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Objective To analyze the relationship between occupational type of patients with colorectal cancer (CRC) and decision-making and curative effect of neoadjuvant therapy in the current version of the Database from Colorectal Cancer (DACCA). Methods The eligible CRC patients were collected from June 29, 2022 updated DACCA according to the screening criteria, in which the data items analyzed included: gender, age, BMI, blood type, marriage, occupation, neoadjuvant therapy, symptomatic changes, imaging changes, and tumor regression grade (TRG), and the occupations were classified into the mental labour group, physical labour group, and the unemployed and resident groups according to the type of labour, then compared the decision-making and curative effect of neoadjuvant therapy among the 3 groups. Results A total of 2 415 eligible data were screened, of which 1 160 (48.0%) were the most in the manual labour group, followed by 877 (36.3%) in the unemployed and resident group, and finally 378 (15.7%) in the mental labour group. The proportion of those who did not use targeted drugs was higher in both patients ≤60 years old and >60 years old [75.6% (958/1 267) vs. 82.5% (947/1 148)], with both differences being statistically significant (P=0.004 and P=0.019), and among patients >60 years old, the different occupational types were associated with symptomatic changes and imaging changes after neoadjuvant therapy, with the highest number of both changes to partial remission [71.5% (161/225) vs. 66.7% (148/222)], both differences being statistically significant (P=0.001 and P=0.017). Conclusion The analysis results of DACCA data reveal that the occupational type of CRC patients was associated with the choice of neoadjuvant therapy, and that different occupational types were associated with changes in curative effect before and after neoadjuvant therapy in CRC patients >60 years old, which needs to be further analysis for the reasons.

Citation： LIU Yuqing, LI Dingling, DU Zekun, WANG Xiaodong, LI Li. Association between occupational type of patients with colorectal cancer and decision making or curative effect of neoadjuvant therapy: a real-world study based on DACCA. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(8): 903-909. doi: 10.7507/1007-9424.202405100 Copy

1.	汪晓东, 刘健博, 李立. 数据库建设第五部分·结直肠癌的肿瘤特征—模块的设计(二). 中国普外基础与临床杂志, 2020, 27(4): 483-488.
2.	汪晓东, 刘健博, 李立. 数据库建设第五部分: 结直肠癌的肿瘤特征—模块的设计(一). 中国普外基础与临床杂志, 2020, 27(3): 345-349.
3.	Benson AB, Venook AP, Al-Hawary MM, et al. Rectal Cancer, Version 2. 2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2022, 20(10): 1139-1167.
4.	汪晓东, 由屹先, 余其澳, 等. 数据库建设第九部分: 结直肠癌新辅助治疗的标签与结构化. 中国普外基础与临床杂志, 2021, 28(6): 799-804.
5.	汪晓东, 李立. 数据库建设第一部分: 个人数据的标签与结构化. 中国普外基础与临床杂志, 2019, 26(3): 335-342.
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7.	国家卫生健康委员会医政司, 中华医学会肿瘤学分会, 顾晋, 等. 中国结直肠癌诊疗规范 (2023版). 消化肿瘤杂志 (电子版), 2023, 15(3): 177-206.
8.	Bruheim K, Guren MG, Skovlund E, et al. Late side effects and quality of life after radiotherapy for rectal cancer. Int J Radiat Oncol Biol Phys, 2010, 76(4): 1005-1011.
9.	Heriot AG, Tekkis PP, Fazio VW, et al. Adjuvant radiotherapy is associated with increased sexual dysfunction in male patients undergoing resection for rectal cancer: a predictive model. Ann Surg, 2005, 242(4): 502-510, 510-511.
10.	Acquati C, Hendren S, Wittmann D, et al. Psychological and sexual distress in rectal cancer patients and partners. Psychooncology, 2022, 31(6): 920-928.
11.	Portale G, Valdegamberi A, Cavallin F, et al. Effect of age and comorbidities on short- and long-term results in patients undergoing laparoscopic curative resection for rectal cancer. J Laparoendosc Adv Surg Tech A, 2019, 29(3): 353-359.
12.	How P, Evans J, Moran B, et al. Preoperative MRI sphincter morphology and anal manometry: can they be markers of functional outcome following anterior resection for rectal cancer?. Colorectal Dis, 2012, 14(6): e339-e345.
13.	胡曦元, 崔文, 郭超. 中国中老年居民体检情况及其前倾、使能、需求、健康行为影响因素分析. 中国公共卫生, 2022, 38(10): 1253-1257.
14.	Hisamatsu Y, Kuriyama N, Fujimoto Y, et al. Indications for laparoscopic surgery for older rectal cancer patients with comorbidities. Surg Today, 2021, 51(5): 721-726.
15.	Feeney G, Sehgal R, Sheehan M, et al. Neoadjuvant radiotherapy for rectal cancer management. World J Gastroenterol, 2019, 25(33): 4850-4869.
16.	Motamedi MAK, Mak NT, Brown CJ, et al. Local versus radical surgery for early rectal cancer with or without neoadjuvant or adjuvant therapy. Cochrane Database Syst Rev, 2023, 6(6): CD002198.

1. 汪晓东, 刘健博, 李立. 数据库建设第五部分·结直肠癌的肿瘤特征—模块的设计(二). 中国普外基础与临床杂志, 2020, 27(4): 483-488.
2. 汪晓东, 刘健博, 李立. 数据库建设第五部分: 结直肠癌的肿瘤特征—模块的设计(一). 中国普外基础与临床杂志, 2020, 27(3): 345-349.
3. Benson AB, Venook AP, Al-Hawary MM, et al. Rectal Cancer, Version 2. 2022, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw, 2022, 20(10): 1139-1167.
4. 汪晓东, 由屹先, 余其澳, 等. 数据库建设第九部分: 结直肠癌新辅助治疗的标签与结构化. 中国普外基础与临床杂志, 2021, 28(6): 799-804.
5. 汪晓东, 李立. 数据库建设第一部分: 个人数据的标签与结构化. 中国普外基础与临床杂志, 2019, 26(3): 335-342.
6. Weiser MR. AJCC 8th edition: colorectal cancer. Ann Surg Oncol, 2018, 25(6): 1454-1455.
7. 国家卫生健康委员会医政司, 中华医学会肿瘤学分会, 顾晋, 等. 中国结直肠癌诊疗规范 (2023版). 消化肿瘤杂志 (电子版), 2023, 15(3): 177-206.
8. Bruheim K, Guren MG, Skovlund E, et al. Late side effects and quality of life after radiotherapy for rectal cancer. Int J Radiat Oncol Biol Phys, 2010, 76(4): 1005-1011.
9. Heriot AG, Tekkis PP, Fazio VW, et al. Adjuvant radiotherapy is associated with increased sexual dysfunction in male patients undergoing resection for rectal cancer: a predictive model. Ann Surg, 2005, 242(4): 502-510, 510-511.
10. Acquati C, Hendren S, Wittmann D, et al. Psychological and sexual distress in rectal cancer patients and partners. Psychooncology, 2022, 31(6): 920-928.
11. Portale G, Valdegamberi A, Cavallin F, et al. Effect of age and comorbidities on short- and long-term results in patients undergoing laparoscopic curative resection for rectal cancer. J Laparoendosc Adv Surg Tech A, 2019, 29(3): 353-359.
12. How P, Evans J, Moran B, et al. Preoperative MRI sphincter morphology and anal manometry: can they be markers of functional outcome following anterior resection for rectal cancer?. Colorectal Dis, 2012, 14(6): e339-e345.
13. 胡曦元, 崔文, 郭超. 中国中老年居民体检情况及其前倾、使能、需求、健康行为影响因素分析. 中国公共卫生, 2022, 38(10): 1253-1257.
14. Hisamatsu Y, Kuriyama N, Fujimoto Y, et al. Indications for laparoscopic surgery for older rectal cancer patients with comorbidities. Surg Today, 2021, 51(5): 721-726.
15. Feeney G, Sehgal R, Sheehan M, et al. Neoadjuvant radiotherapy for rectal cancer management. World J Gastroenterol, 2019, 25(33): 4850-4869.
16. Motamedi MAK, Mak NT, Brown CJ, et al. Local versus radical surgery for early rectal cancer with or without neoadjuvant or adjuvant therapy. Cochrane Database Syst Rev, 2023, 6(6): CD002198.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Association between occupational type of patients with colorectal cancer and decision making or curative effect of neoadjuvant therapy: a real-world study based on DACCA

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