Objective To analyze the relationship between the residence and oncological characteristics of colorectal patients served by Sichuan University West China Hospital as a regional center in the current version of the Database from Colorectal Cancer (DACCA). Methods The DACCA version selected for this data analysis was the updated version on January 5, 2022. The data items analyzed included: residence, precancerous lesions, family history of cancer, tumor location, tumor morphology, tumor orientation, tumor pathology, tumor differentiation and preoperative TNM staging. According to the regional distribution of colorectal cancer patients' residence in the database, they were divided into Sichuan group and non-Sichuan group, and the Sichuan group was further divided into Sichuan-Chengdu group and Sichuan-non-Chengdu group. Results The DACCA database was filtered by conditions to obtain 7 232 valid data. ① The composition ratio of precancerous lesions in different places of residence: The difference between the Sichuan group and the non-Sichuan group was statistically significant (χ2=14.462, P=0.003), and the difference between the Sichuan-Chengdu group and the Sichuan-non-Chengdu group was not statistically significant (χ2=7.591, P=0.101). ② Composition ratio of family history of cancer in different places of residence: In the family history of cancer in oneself, the difference between Sichuan group and non-Sichuan group as well as between Sichuan-Chengdu group and Sichuan-non-Chengdu group were not statistically significant (χ2=1.121, P=0.606; χ2=1.047, P=0.621). In the family history of cancer in relatives, the differences in the composition ratio of different tumor histories between the Sichuan group and the non-Sichuan group, and between the Sichuan-Chengdu group and the Sichuan-non-Chengdu group were not statistically significant (χ2=0.813, P=0.692; χ2=2.696, P=0.262). ③ Tumor site composition ratios in different places of residence: The difference between Sichuan group and non-Sichuan group was not statistically significant (χ2=0.476, P=0.490), and the difference between Sichuan-Chengdu group and Sichuan-non-Chengdu group was statistically significant (χ2=36.216, P<0.001). ④ Tumor morphology composition ratio in different places of residence: The difference between Sichuan group and non-Sichuan group was statistically significant (χ2=19.560, P<0.001), and the difference between Sichuan-Chengdu group and Sichuan-non-Chengdu group was not statistically significant (χ2=5.377, P=0.247). ⑤ Composition ratio of tumor orientation in different places of residence: The differences in composition ratio of tumor orientation between Sichuan group and non-Sichuan group and between Sichuan-Chengdu group and Sichuan-non-Chengdu group were statistically significant (χ2=17.484, P=0.005; χ2=26.820, P<0.001). ⑥ Composition ratio of tumor pathological properties under different residence: The differences in the comparison of pathological properties between Sichuan group and non-Sichuan group as well as between Sichuan-Chengdu group and Sichuan-non-Chengdu group of CRC patients were not statistically significant (χ2=8.136, P=0.408; χ2=7.278, P=0.506). ⑦ Composition ratio of tumor differentiation degree under different residence groupings: the differences in the composition ratio of tumors with different degrees of differentiation were not statistically significant between Sichuan group and non-Sichuan group, and between Sichuan-Chengdu group and Sichuan-non-Chengdu group (H=0.289, P=0.591; H=0.156, P=0.693). ⑧ The composition ratio of TNM staging of tumors before operation in different places of residence: between the Sichuan group and the non-Sichuan group, the difference in the composition ratio of preoperative TNM staging of CRC patients was statistically significant (H=8.023, P=0.005); between the Sichuan-Chengdu group and the Sichuan-non-Chengdu group, the difference in the composition ratio of preoperative TNM staging of CRC patients was not statistically significant (H=0.218, P=0.640). Conclusions Data analysis in DACCA reveal multiple associations between the place of residence and oncological characteristics of CRC patients. There are differences in the composition of the types of precancerous lesions among CRC patients in different places of residence. The proportion of CRC is higher in the family history of cancer. In terms of the site of tumor occurrence, the proportion of tumors located in the rectum is higher than that in the colon. In the composition of tumor morphology in all regions, the ulcerative type is the most frequent. The composition of tumor orientation is different in patients with CRC, and those who has involved a circle of the intestinal wall are the most frequent. Most CRC patients are already in middle or late stage when the tumor is discovered, and the proportion of middle or late stage patients in non-Sichuan provinces was even higher.
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 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.
Objective To analyze the impact of age on surgical reaction and postoperative complications of patients with colorectal cancer served by West China Hospital of Sichuan University as a regional center in the Database from Colorectal Cancer (DACCA). Methods The data of DACCA was updated on January 5, 2022. All data items included age, surgical trauma reaction, elevated body temperature time, exhaust time, pain, mental status, and postoperative hospital complications. According to the age segmentation method in China, the patients can be divided into 3 groups: ≤35 years old (including infant, toddler, child, teenager and youth, set as the younger group), 36–59 years old (set as the middle-aged group), and ≥60 years old (set as the elderly group). Results After scanning, 5 224 data rows were analyzed. There was no significant difference in surgical trauma reaction (H=0.352, P=0.838), elevated body temperature time (H=3.999, P=0.135), exhaust time (H=1.940, P=0.379), mental status (H=2.075, P=0.354), incidence of postoperative complications (χ2=2.078, P=0.354), incidence of anastomotic bleeding (χ2=1.737, P=0.420), incidence of anastomotic leakage (χ2=0.573, P=0.751), and incidence of pulmonary infection (P=0.410) among different age groups, but the younger group had more severe pain (H=12.985, P=0.002) and higher incidence of inflammatory obstruction (χ2=7.789, P=0.020). Conclusions Age has little effect on trauma reaction related parameters and overall incidence of complications in colorectal cancer patients. However, younger patients with colorectal cancer showed increased pain levels and increased incidence of inflammatory obstruction after surgery. These clinical manifestations can provide clinicians with evidence for intervention, but more prospective intervention trials are needed.