Relation between age of patients with colorectal cancer and decision-making and treatment effect of neoadjuvant regimens: a real-world study based on DACCA_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Zhen ^1,2 , WU Yan ^1,2 , LIN Rongruo ^1,2 , YANG Hongzhao ^1,2 , WANG Xiaodong ^1,2 ,  LI Li ^1,2

1. Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Medicine in Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

LI Li, Email: drlili116@126.com

Keywords：

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

DOI：

10.7507/1007-9424.202205020

Video：

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Objective To analyze the relation between the age of patients with colorectal cancer and neoadjuvant therapy (NAT) regimen decision-making and outcomes in the current version of the Database from Colorectal Cancer (DACCA). Methods The version of DACCA selected for this analysis was updated on January 5, 2022. The patients were enrolled according to the established screening criteria and then assigned to 3 age groups: ≤45, 45–65, and ≥65 years old groups. The differences in the NAT regimen decision-making and changes of symptom, imaging, and cancer markers in these 3 age groups were analyzed. Results A total of 4 882 data that met the screened criteria were enrolled. The results of statistical analysis showed that the difference in the constituent ratio of patients chosen NAT strategies among 3 age groups was not statistically significant (χ²=8.885, P=0.180). There was a statistical difference in the constituent ratio of patients chosen combined target drug among 3 age groups (χ²=8.530, P=0.014), it was found that the proportion of the patients with ≤45 years old adopting combined target drug regimen was higher. Although the changes of symptom (H=12.299, P=0.056), image (H=1.775, P=0.412), and cancer markers (H=11.351, P=0.183) had no statistical differences of the 3 age groups after NAT, it was found that the proportions of patients with ≥65 years old with progresses of symptom and imaging changes and elevated cancer markers after NAT were higher, and the proportions of patients with ≤45 years old with complete and partial remissions of symptom and imaging changes and with normal cancer markers after NAT were higher. Conclusions Through analysis of DACCA data, it is found that in the selection of NAT strategy for colorectal cancer, the lower age group, the higher proportion of patients adopting combined target drug regimen. Although it is not found that age is related to changes of symptoms, imaging, and cancer markers after NAT, it still shows a trend of better outcomes in younger patients.

Citation： ZHAO Zhen, WU Yan, LIN Rongruo, YANG Hongzhao, WANG Xiaodong, LI Li. Relation between age of patients with colorectal cancer and decision-making and treatment effect of neoadjuvant regimens: a real-world study based on DACCA. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(7): 946-950. doi: 10.7507/1007-9424.202205020 Copy

1.	中華人民共和國國家衛生健康委員會醫政醫管局, 中華醫學會腫瘤學分會. 中國結直腸癌診療規范(2020年版). 中國實用外科雜志, 2020, 40(6): 601-625.
2.	艾瀟琳, 汪曉東, 李立. 大腸癌新輔助化療療效評價方法的研究進展. 胃腸病學和肝病學雜志, 2015, 24(7): 773-776.
3.	汪曉東, 由屹先, 余其澳, 等. 數據庫建設第九部分: 結直腸癌新輔助治療的標簽與結構化. 中國普外基礎與臨床雜志, 2021, 28(6): 799-804.
4.	Sarasqueta C, Perales A, Escobar A, et al. Impact of age on the use of adjuvant treatments in patients undergoing surgery for colorectal cancer: patients with stage Ⅲ colon or stage Ⅱ/Ⅲ rectal cancer. BMC Cancer, 2019, 19(1): 735. doi: 10.1186/s12885-019-5910-z.
5.	He F, Chen M, Xiao WW, et al. Oncologic and survival outcomes in elderly patients with locally advanced rectal cancer receiving neoadjuvant chemoradiotherapy and total mesorectal excision. Jpn J Clin Oncol, 2021, 51(9): 1391-1399.
6.	Tandon P, Reddy KR, O’Leary JG, et al. A Karnofsky performance status-based score predicts death after hospital discharge in patients with cirrhosis. Hepatology, 2017, 65(1): 217-224.
7.	Yu Y, Carey M, Pollett W, et al. The long-term survival characteristics of a cohort of colorectal cancer patients and baseline variables associated with survival outcomes with or without time-varying effects. BMC Med, 2019, 17(1): 150. doi: 10.1186/s12916-019-1379-5.
8.	汪曉東, 曾天芳, 楊妍姣, 等. 多學科協作診治模式下老年結直腸癌患者應用新輔助化療聯合手術治療的臨床效果. 中國普外基礎與臨床雜志, 2008, 15(10): 773-777.
9.	Sugimoto K, Sakamoto K, Ii Y, et al. Significance of postoperative adjuvant chemotherapy with an oxaliplatin-based regimen after simultaneous curative resection for colorectal cancer and synchronous colorectal liver metastasis: a propensity score matching analysis. BMC Surg, 2021, 21(1): 188. doi: 10.1186/s12893-021-01193-4.
10.	Horvat N, Veeraraghavan H, Khan M, et al. MR imaging of rectal cancer: radiomics analysis to assess treatment response after neoadjuvant therapy. Radiology, 2018, 287(3): 833-843.
11.	Sanoff HK, Carpenter WR, Stürmer T, et al. Effect of adjuvant chemotherapy on survival of patients with stage III colon cancer diagnosed after age 75 years. J Clin Oncol, 2012, 30(21): 2624-2634.
12.	韓潞, 江勇, 譚衛林. CEA和CA19-9在結直腸癌組織中的表達及臨床意義. 實用癌癥雜志, 2015, 30(1): 25-27.
13.	惠菲菲, 劉凱, 范明明, 等. 伴有肝轉移的結直腸癌患者血清CEA、CA199的分析. 中華結直腸疾病電子雜志, 2015, 4(4): 47-52.
14.	李會平, 代愛軍. 結直腸癌患者術前血清癌胚抗原及糖類抗原19-9陽性與臨床病理學特征的關系. 中國肛腸病雜志, 2019, 39(1): 1-3.
15.	李旺林, 曹杰, 唐偉鏢. 血清CEA檢測在結直腸癌患者中的臨床意義. 熱帶醫學雜志, 2005, 5(2): 179-181.
16.	劉昕, 劉騫. 結直腸癌患者術前血清CA19-9、CEA、TPS水平與臨床病理因素的相關性分析. 中華結直腸疾病電子雜志, 2013, 2(5): 230-233.
17.	王靜, 袁玉軍. 術前CEA、D-二聚體、纖維蛋白原與結直腸癌臨床病理特點、分期及預后相關性研究. 國際檢驗醫學雜志, 2019, 40(6): 690-693.
18.	楊松海, 鄧躍華, 劉傳磊, 等. HSP gp96和CEA在結直腸癌中的表達及臨床意義的研究. 安徽醫藥, 2012, 16(10): 1444-1446.

1. 中華人民共和國國家衛生健康委員會醫政醫管局, 中華醫學會腫瘤學分會. 中國結直腸癌診療規范(2020年版). 中國實用外科雜志, 2020, 40(6): 601-625.
2. 艾瀟琳, 汪曉東, 李立. 大腸癌新輔助化療療效評價方法的研究進展. 胃腸病學和肝病學雜志, 2015, 24(7): 773-776.
3. 汪曉東, 由屹先, 余其澳, 等. 數據庫建設第九部分: 結直腸癌新輔助治療的標簽與結構化. 中國普外基礎與臨床雜志, 2021, 28(6): 799-804.
4. Sarasqueta C, Perales A, Escobar A, et al. Impact of age on the use of adjuvant treatments in patients undergoing surgery for colorectal cancer: patients with stage Ⅲ colon or stage Ⅱ/Ⅲ rectal cancer. BMC Cancer, 2019, 19(1): 735. doi: 10.1186/s12885-019-5910-z.
5. He F, Chen M, Xiao WW, et al. Oncologic and survival outcomes in elderly patients with locally advanced rectal cancer receiving neoadjuvant chemoradiotherapy and total mesorectal excision. Jpn J Clin Oncol, 2021, 51(9): 1391-1399.
6. Tandon P, Reddy KR, O’Leary JG, et al. A Karnofsky performance status-based score predicts death after hospital discharge in patients with cirrhosis. Hepatology, 2017, 65(1): 217-224.
7. Yu Y, Carey M, Pollett W, et al. The long-term survival characteristics of a cohort of colorectal cancer patients and baseline variables associated with survival outcomes with or without time-varying effects. BMC Med, 2019, 17(1): 150. doi: 10.1186/s12916-019-1379-5.
8. 汪曉東, 曾天芳, 楊妍姣, 等. 多學科協作診治模式下老年結直腸癌患者應用新輔助化療聯合手術治療的臨床效果. 中國普外基礎與臨床雜志, 2008, 15(10): 773-777.
9. Sugimoto K, Sakamoto K, Ii Y, et al. Significance of postoperative adjuvant chemotherapy with an oxaliplatin-based regimen after simultaneous curative resection for colorectal cancer and synchronous colorectal liver metastasis: a propensity score matching analysis. BMC Surg, 2021, 21(1): 188. doi: 10.1186/s12893-021-01193-4.
10. Horvat N, Veeraraghavan H, Khan M, et al. MR imaging of rectal cancer: radiomics analysis to assess treatment response after neoadjuvant therapy. Radiology, 2018, 287(3): 833-843.
11. Sanoff HK, Carpenter WR, Stürmer T, et al. Effect of adjuvant chemotherapy on survival of patients with stage III colon cancer diagnosed after age 75 years. J Clin Oncol, 2012, 30(21): 2624-2634.
12. 韓潞, 江勇, 譚衛林. CEA和CA19-9在結直腸癌組織中的表達及臨床意義. 實用癌癥雜志, 2015, 30(1): 25-27.
13. 惠菲菲, 劉凱, 范明明, 等. 伴有肝轉移的結直腸癌患者血清CEA、CA199的分析. 中華結直腸疾病電子雜志, 2015, 4(4): 47-52.
14. 李會平, 代愛軍. 結直腸癌患者術前血清癌胚抗原及糖類抗原19-9陽性與臨床病理學特征的關系. 中國肛腸病雜志, 2019, 39(1): 1-3.
15. 李旺林, 曹杰, 唐偉鏢. 血清CEA檢測在結直腸癌患者中的臨床意義. 熱帶醫學雜志, 2005, 5(2): 179-181.
16. 劉昕, 劉騫. 結直腸癌患者術前血清CA19-9、CEA、TPS水平與臨床病理因素的相關性分析. 中華結直腸疾病電子雜志, 2013, 2(5): 230-233.
17. 王靜, 袁玉軍. 術前CEA、D-二聚體、纖維蛋白原與結直腸癌臨床病理特點、分期及預后相關性研究. 國際檢驗醫學雜志, 2019, 40(6): 690-693.
18. 楊松海, 鄧躍華, 劉傳磊, 等. HSP gp96和CEA在結直腸癌中的表達及臨床意義的研究. 安徽醫藥, 2012, 16(10): 1444-1446.

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CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Relation between age of patients with colorectal cancer and decision-making and treatment effect of neoadjuvant regimens: a real-world study based on DACCA

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