Relation between residence place and long-term prognosis of colorectal cancer patients in a single-center: a real-world data study based on DACCA_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHANG Huanxin ^1,2 , HE Ziyan ^1,2 , BAI Yaning ^1,2 ,  WANG Xiaodong ^2,3 , XIANG Haiping ^3,4 , LI Li ⁵

1. West China School of Medicine, Sichuan University, Chengdu 610041, P. R. China;
2. Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. Sichuan Provincial Health Information Society, Chengdu 610041, P. R. China;
4. Health Information Center of Sichuan Province, Chengdu 610041, P. R. China;
5. Colorectal Cancer Center, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding?author：

WANG Xiaodong, Email: wangxiaodong@wchscu.cn

Keywords：

residence place; colorectal cancer; distribution; prognosis; Database from Colorectal Cancer

DOI：

10.7507/1007-9424.202310041

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Objective To analyze the distribution, prognostic differences, and characteristics of patients with colorectal cancer (CRC) from 2007 to 2022 based on the current version of the Database from Colorectal Cancer (DACCA), so as to provide a basis for clinical decision-making. Methods The eligible CRC patients based on the established screening criteria from the updated DACCA were collected. The distribution and survival status of CRC patients in different residence places were analyzed. The residence places included 21 cities (prefectures) within Sichuan Province. Results A total of 5 416 cases that met the screening criteria from 2007 to 2022 were collected. Among these, CRC patients were predominantly concentrated in Chengdu (44.77%), Meishan (5.78%), and Nanchong (4.56%) cities. A heatmap depicting the superimposed trend of CRC patients origins revealed the distribution of patients was basically divided into eastern and western regions along the axis of “Mianyang–Chengdu–Yaan cities”. The majority of patients (5 359 cases, 98.95%) was distributed in the eastern region, while a few in the western region (57 cases, 1.05%). The patients in the eastern region were more high clustered (especially Chengdu city), while those in the western region was sporadically dispersed, and the patients in the western region increased slowly without aggregation. The 1, 3, and 5-year cumulative overall survival rates of the CRC patients in the DACCA were 96.2%, 89.7%, and 85.1%, respectively. The multivariate Cox proportional hazards regression model showed that the male, age ≥35-year old, adenocarcinoma (mucinous adenocarcinoma as a reference), poorly differentiated degree, pTNM stages Ⅲ and Ⅳ, obstruction, and perforation were the risk factors for median overall survival shortening in the CRC patients (all P<0.05). The survival curve of patients with CRC drawn by Kaplan-Meier method showed that the overall survival of CRC patients in different cities (prefectures) had no statistical differences as compared with the integral CRC patients (P>0.05), except for Neijiang city (was worse than that of the integral CRC patients, P<0.05). Conclusions Based on data analysis for the DACCA from 2007 to 2022, the majority of CRC patients clusters in the eastern region. Chengdu city exhibits a high clustering, while the western region shows a sporadic distribution without aggregation phenomena. It is found that the cumulative overall survival of CRC patients in Neijiang city is worse than that of the integral CRC patients, while which in the other cities (prefectures) was relatively close to that of the integral CRC patients in Sichuan Province.

Citation： ZHANG Huanxin, HE Ziyan, BAI Yaning, WANG Xiaodong, XIANG Haiping, LI Li. Relation between residence place and long-term prognosis of colorectal cancer patients in a single-center: a real-world data study based on DACCA. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2024, 31(1): 32-39. doi: 10.7507/1007-9424.202310041 Copy

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2.	GBD 2019 Colorectal Cancer Collaborators. Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol, 2022, 7(7): 627-647.
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10.	汪曉東, 朱佳怡, 李立. 數據庫建設第十一部分: 結直腸癌隨訪的標簽與結構化. 中國普外基礎與臨床雜志, 2021, 28(10): 1353-1359.
11.	何林娟, 黃薪萌. 四川省五大經濟區協同創新發展的現狀與建議. 科技中國, 2023, (4): 82-86..
12.	龔佳祺, 劉瑩, 曾渝, 等. 結直腸癌患者的就診年齡與術前腫瘤相關特征的關系: 基于DACCA的真實世界數據研究. 中國普外基礎與臨床雜志, 2022, 29(3): 362-370.
13.	國際生命科學學會中國辦事處中國肥胖問題工作組聯合數據匯總分析協作組. 中國成人體質指數分類的推薦意見簡介. 中華預防醫學雜志, 2001, 35(5): 349-350.
14.	Azur MJ, Stuart EA, Frangakis C, et al. Multiple imputation by chained equations: what is it and how does it work?. Int J Methods Psychiatr Res, 2011, 20(1): 40-49.
15.	Qu R, Ma Y, Zhang Z, et al. Increasing burden of colorectal cancer in China. Lancet Gastroenterol Hepatol, 2022, 7(8): 700.
16.	Dutta A, Pratiti R, Kalantary A, et al. Colorectal cancer: a systematic review of the current situation and screening in North and central Asian countries. Cureus, 2023, 15(1): e33424.
17.	Wong MCS, Huang J, Lok V, et al. Differences in incidence and mortality trends of colorectal cancer worldwide based on sex, age, and anatomic location. Clin Gastroenterol Hepatol, 2021, 19(5): 955-966.
18.	章金城, 周文佐. 四川省地形起伏度與人口經濟的空間自相關關系. 水土保持通報, 2019, 39(1): 250-257.
19.	Van Blarigan EL, Ou FS, Bainter TM, et al. Associations between unprocessed red meat and processed meat with risk of recurrence and mortality in patients with stage Ⅲ colon cancer. JAMA Netw Open, 2022, 5(2): e220145.
20.	Islami F, Chen W, Yu XQ, et al. Cancer deaths and cases attributable to lifestyle factors and infections in China, 2013. Ann Oncol, 2017, 28(10): 2567-2574.
21.	Cheng E, Ou FS, Ma C, et al. Diet- and lifestyle-based prediction models to estimate cancer recurrence and death in patients with stage Ⅲ colon cancer (CALGB 89803/Alliance). J Clin Oncol, 2022, 40(7): 740-751.
22.	Kim JM, Chung E, Cho ES, et al. Impact of subcutaneous and visceral fat adiposity in patients with colorectal cancer. Clin Nutr, 2021, 40(11): 5631-5638.
23.	Wang R, Lian J, Wang X, et al. Survival rate of colorectal cancer in China: A systematic review and meta-analysis. Front Oncol, 2023, 13: 1033154.
24.	Li K, Peng W, Zhou Y, et al. Host genetic and environmental factors shape the composition and function of gut microbiota in populations living at high altitude. Biomed Res Int, 2020, 2020: 1482109.

1. Zhou J, Zheng R, Zhang S, et al. Colorectal cancer burden and trends: comparison between China and major burden countries in the world. Chin J Cancer Res, 2021, 33(1): 1-10.
2. GBD 2019 Colorectal Cancer Collaborators. Global, regional, and national burden of colorectal cancer and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Gastroenterol Hepatol, 2022, 7(7): 627-647.
3. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
4. Keum N, Giovannucci E. Global burden of colorectal cancer: emerging trends, risk factors and prevention strategies. Nat Rev Gastroenterol Hepatol, 2019, 16(12): 713-732.
5. Yang Y, Han Z, Li X, et al. Epidemiology and risk factors of colorectal cancer in China. Chin J Cancer Res, 2020, 32(6): 729-741.
6. 劉桂娜, 曾渝, 劉健博, 等. 數據庫輔助研究: 區域醫療中心的結直腸癌地理散發特征—結合Tableau地圖分析技術的真實世界數據報道. 中國普外基礎與臨床雜志, 2020, 27(1): 88-96.
7. 汪曉東, 李希, 何欣林, 等. 數據庫研究第一部分: 區域性醫療中心的結直腸癌與人群特征. 中國普外基礎與臨床雜志, 2019, 26(2): 212-220.
8. 汪曉東, 劉健博, 李立.數據庫建設第五部分·結直腸癌的腫瘤特征—模塊的設計(二). 中國普外基礎與臨床雜志, 2020, 27(4): 483-488.
9. 汪曉東, 劉健博, 李立. 數據庫建設第六部分: 結直腸癌分期的標簽與結構化. 中國普外基礎與臨床雜志, 2020, 27(7): 873-879.
10. 汪曉東, 朱佳怡, 李立. 數據庫建設第十一部分: 結直腸癌隨訪的標簽與結構化. 中國普外基礎與臨床雜志, 2021, 28(10): 1353-1359.
11. 何林娟, 黃薪萌. 四川省五大經濟區協同創新發展的現狀與建議. 科技中國, 2023, (4): 82-86..
12. 龔佳祺, 劉瑩, 曾渝, 等. 結直腸癌患者的就診年齡與術前腫瘤相關特征的關系: 基于DACCA的真實世界數據研究. 中國普外基礎與臨床雜志, 2022, 29(3): 362-370.
13. 國際生命科學學會中國辦事處中國肥胖問題工作組聯合數據匯總分析協作組. 中國成人體質指數分類的推薦意見簡介. 中華預防醫學雜志, 2001, 35(5): 349-350.
14. Azur MJ, Stuart EA, Frangakis C, et al. Multiple imputation by chained equations: what is it and how does it work?. Int J Methods Psychiatr Res, 2011, 20(1): 40-49.
15. Qu R, Ma Y, Zhang Z, et al. Increasing burden of colorectal cancer in China. Lancet Gastroenterol Hepatol, 2022, 7(8): 700.
16. Dutta A, Pratiti R, Kalantary A, et al. Colorectal cancer: a systematic review of the current situation and screening in North and central Asian countries. Cureus, 2023, 15(1): e33424.
17. Wong MCS, Huang J, Lok V, et al. Differences in incidence and mortality trends of colorectal cancer worldwide based on sex, age, and anatomic location. Clin Gastroenterol Hepatol, 2021, 19(5): 955-966.
18. 章金城, 周文佐. 四川省地形起伏度與人口經濟的空間自相關關系. 水土保持通報, 2019, 39(1): 250-257.
19. Van Blarigan EL, Ou FS, Bainter TM, et al. Associations between unprocessed red meat and processed meat with risk of recurrence and mortality in patients with stage Ⅲ colon cancer. JAMA Netw Open, 2022, 5(2): e220145.
20. Islami F, Chen W, Yu XQ, et al. Cancer deaths and cases attributable to lifestyle factors and infections in China, 2013. Ann Oncol, 2017, 28(10): 2567-2574.
21. Cheng E, Ou FS, Ma C, et al. Diet- and lifestyle-based prediction models to estimate cancer recurrence and death in patients with stage Ⅲ colon cancer (CALGB 89803/Alliance). J Clin Oncol, 2022, 40(7): 740-751.
22. Kim JM, Chung E, Cho ES, et al. Impact of subcutaneous and visceral fat adiposity in patients with colorectal cancer. Clin Nutr, 2021, 40(11): 5631-5638.
23. Wang R, Lian J, Wang X, et al. Survival rate of colorectal cancer in China: A systematic review and meta-analysis. Front Oncol, 2023, 13: 1033154.
24. Li K, Peng W, Zhou Y, et al. Host genetic and environmental factors shape the composition and function of gut microbiota in populations living at high altitude. Biomed Res Int, 2020, 2020: 1482109.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Relation between residence place and long-term prognosis of colorectal cancer patients in a single-center: a real-world data study based on DACCA

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