ObjectiveTo analyze the relation between the place of residence of patients with colorectal cancer (CRC) and patient compliance or regimen decision-making or outcomes for neoadjuvant therapy (NAT) in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe version of DACCA selected for this analysis was updated on June 29, 2022. The patients were enrolled according to the established screening criteria and then assigned into inside and outside of Sichuan Province groups as well as inside and outside of Chengdu City groups. The differences in the patient compliance or regimen decision-making or outcomes (changes of symptom and imaging, and cancer marker carcinoembryonic antigen) for NAT were analyzed. ResultsA total of 3 574 data that met the screened criteria were enrolled, 3 142 (87.91%) and 432 (12.09%) were inside of Sichuan Province group and outside of Sichuan Province group, respectively; 1 340 (42.65%) and 1 802 (57.35%) were inside of Chengdu City group and outside of Chengdu City group in Sichuan Province, respectively. ① The constituent ratios of the patient compliance for NAT had no statistical differences between the inside and outside of Sichuan Province groups (χ2=0.299, P=0.585) as well as between the inside and outside of Chengdu City groups (χ2=3.109, P=0.078). ② In terms of the impact of the place of residence on the decision-making of NAT: For the patients with targeted therapy or not, there was a statistical difference between the inside and outside of Sichuan Province groups (χ2=5.047, P=0.025), but which had no statistical difference between the inside and outside of Chengdu City groups (χ2=0.091, P=0.762); For the patients with radiotherapy or not, there were no statistical differences in the constituent ratios of patients between the inside and outside of Sichuan Province groups as well as between the inside and outside of Chengdu City groups (χ2=2.215, P=0.137; χ2=2.964, P=0.085); For the neoadjuvant intensity, there was a statistical difference between the inside and outside of Sichuan Province groups (χ2=12.472, P=0.002), but which had no statistical difference between the inside and outside of Chengdu City groups (χ2=2.488, P=0.288). ③ The outcomes for NAT: The changes of carcinoembryonic antigen had no statistical differences between the inside and outside of Sichuan Province groups as well as between the inside and outside of Chengdu City groups (H=1.762, P=0.184; H=3.531, P=0.060); In the symptom changes, there was a statistical difference between the inside and outside of Sichuan Province groups (χ2=3.896, P=0.048), which had no statistical difference between the inside and outside of Chengdu City groups (χ2=0.016, P=0.900); In the image changes, the difference was statistically significant between the inside and outside of Chengdu City groups (χ2=7.975, P=0.005), but which had no statistical difference between the inside and outside of Sichuan Province groups (χ2=0.063, P=0.802). ConclusionsThrough data analysis in DACCA in this study, it is found that there are no statistical differences in compliance and carcinoembryonic antigen changes. However, decision-making of NAT for patients of inside and outside of Sichuan Province has different choices on whether to assist targeted therapy and chemotherapy intensity for NAT; Symptom changes of NAT in patients of inside of Sichuan Province has a better effect than in patients of outside of Sichuan Province; Imaging change of NAT in patients of inside of Chengdu City has a better effect than in patients of outside of Chengdu City.
Evidence-based medicine database is a type of digital resource, which is based on principles of evidence-based medicine. It collects clinical evidence as a major content to serve clinical decision-making. This paper focused on various types of evidence-based databases, such as clinical practice guidelines, systematic reviews, and clinical trials. After collecting some representative databases, it analyzed and compared their contents, functions and characteristics, in attempt to enhance understanding of the current situation and trends of development of evidence-based medicine databases.
Objective To learn the bibliometric characteristics of Chinese ophthalmological papers indexed in SCI database from 2007 to 2011.Methods All the ophthalmological papers published in the source journals indexed in the SCI database from 2007 to 2011 were retrieved. The papers of first authors were manually selected for bibliometric analysis.Results The ophthalmological papers published by Chinese scholars as the first author were 478, 482, 698, 791, and 1049 from 2007 to 2011 (total 3498). The five institutions that published papers in the most were Sun Yat-sen University, Capital University of Medical Sciences, Fudan University, Hong Kong Chinese University and Shanghai Jiaotong University. The papers were distributed in 625 journals. The top five journals the papers were published in were Molecular Vision (332), International Journal of Ophthalmology (268), Investigative Ophthalmology amp; Visual Science (206), Chinese Medical Journal (109), and Graefeprime;s Archive for Clinical and Experimental Ophthalmology (104). The 3498 papers were cited 12 030 times, 3.44 times per paper. The rate of non-cited articles for 5 year,3 year and 2 year periods were 12.55%, 24.21% and 38.43% respectively. Conclusions Chinese ophthalmological papers indexed in SCI database have gradually increased. Chinese ophthalmological papers mainly originate in the affiliated hospital of universities and colleges. There are four ophthalmologic professional periodicals included in the top five in the quantity of articles.
ObjectiveTo explore the influencing factors of cancer-specific survival of patients with large hepatocellular carcinoma, and draw a nomogram to predict the cancer-specific survival rate of large hepatocellular carcinoma patients.MethodsThe clinicopathological data of patients with large hepatocellular carcinoma during the period from 1975 to 2017 in the Surveillance, Epidemiology, and End Results (SEER) database were searched and randomly divided into training group and validation group at 1∶1. Using the training data, the Cox proportional hazard regression model was used to explore the influencing factors of cancer-specific survival and construct the nomogram; finally, the receiver operating characteristic curve (ROC curve) and the calibration curve were drawn to verify the nomogram internally and externally.ResultsThe results of the multivariate Cox proportional hazard regression model showed that the degree of liver cirrhosis, tumor differentiation, tumor diameter, T stage, M stage, surgery, and chemotherapy were independent influencing factors that affect the specific survival of patients with large hepatocellular carcinoma (P<0.05), and then these factors were enrolled into the nomogram of the prediction model. The areas under the 1, 3, and 5-year curves of the training group were 0.800, 0.827, and 0.814, respectively; the areas under the 1, 3, and 5-year curves of the validation group were 0.800, 0.824, and 0.801, respectively. The C index of the training group was 0.779, and the verification group was 0.777. The calibration curve of the training group and the verification group was close to the ideal curve of the actual situation.ConclusionThe nomogram of the prediction model drawn in this study can be used to predict the specific survival of patients with large hepatocellular carcinoma in the clinic.
ObjectiveTo construct a model for predicting prognosis risk in patients with pancreatic malignancy (PM).MethodsThe clinicopathological data of 8 763 patients with PM undergone resection between 2010 and 2015 were collected and analyzed by SEER*Stat (v8.3.5) and R software, respectively. The univariate and multivariate Cox proportional hazard regression analysis were used to analyze the factors for predicting prognosis outcome risk and constructed the nomograms of patients with PM, respectively. Kaplan-Meier method was used to evaluate the survival of patients according to relevant factors and the high risk group and low risk group of patients with PM. The discriminative ability and calibration of the nomograms to predict overall survival were tested by using C-index, area under ROC curve (AUC) and calibration plots.ResultsThe multivariate Cox proportional hazard regression analysis showed that age, T staging, N staging, M staging, histological type, the differentiation, number of regional lymph node dissection, chemotherapy, and radiotherapy were independent factors for predicting the prognosis of patients with PM (P<0.05). Based on regression analysis of patients with PM, a nomograms model for predicting the risk of patients with PM was established, including age, T staging, N staging, M staging, histological type, the differentiation, tumor location, type of surgery, number of regional lymph node dissection, chemotherapy, and radiotherapy. The discriminative ability and calibration of the nomograms revealed good predictive ability as indicated by the C-index (0.747 for modeling group and 0.734 for verification group). The 3- and 5-year survival AUC values of the modeling group were 0.766 and 0.781, and the validation group were 0.758 and 0.783, respectively. The calibration plots showed that predictive value of the 3- and 5-year survival were close to the actual values in both modeling group and the verification group. ConclusionsIndependent predictors of survival risk after curative-intent surgery for PM were selected to create nomograms for predicting overall survival. The nomograms provide a basis for judging the prognosis of PM patients.
ObjectiveTo analyze the relation between the marital status of patients with colorectal cancer and surgical treatment options decision-making and outcomes in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe version of DACCA selected for this analysis was updated on August 31, 2022. The patients were enrolled according to the established screening criteria and then assigned to 3 groups: the unmarried, married, and divorced or widowed groups. The differences in the surgical modality decisions, surgical quality, and surgical complications among these 3 groups were analyzed. ResultsA total of 7 634 data that met the screened criteria were enrolled. It was found that the difference in the composition of the willingness to conserve anus among patients with different marital status was statistically significant (χ2=28.635, P<0.001), reflecting that the willingness to conserve anus was “strong” among unmarried and married patients, and the overall willingness to conserve anus was relatively more positive among unmarried patients, while the willingness to conserve anus was “rational” among widowed or divorced patients. No statistical differences were found in the surgical modality decisions (rectal surgery: χ2=0.493, P=0.782; colon surgery: χ2=0.213, P=0.899), including the presence of prophylactic stoma for the patient with radical resection (χ2=5.156, P=0.076）, surgical quality (H=3.452, P=0.178）, presence of surgical in-hospital complications (χ2=1.663, P=0.435), and the presence of short-term surgical complications (χ2=1.695, P=0.428). ConclusionsAnalysis of the data in DACCA reveals that there is difference in willingness to preserve anus among colorectal cancer patients with different marital status. Married and unmarried patients have stronger anal preservation intention, suggesting that clinical care and family support should be strengthened during clinical diagnosis and treatment.
ObjectiveTo analyze the association between preoperative staging (cTNM) and neoadjuvant therapy regimen decision-making and efficacy in patients with rectal cancer in the current version of Database from Colorectal Cancer (DACCA). MethodsThe data analysis for this study selected the DACCA version updated on April 20, 2024. The patient information was collected and categorized into three stages (Ⅱ, Ⅲ, and Ⅳ). The differences in neoadjuvant treatment decision-making and therapeutic effects, including gross changes, imaging changes, and tumor regression grade (TRG), were analyzed. ResultsA total of 3 158 eligible cases were collected in this study, with complete preoperative staging and neoadjuvant therapy decision-making data available for 2 370 patients. There were statistically significant differences in the overall comparison among the patients with rectal cancer in terms of the selection of combined targeted therapy, radiotherapy regimens, and the intensity of neoadjuvant chemotherapy by patients at different preoperative stages (χ2=42.239, P<0.001; χ2=41.615, P<0.001; H=1.161, P=0.004). Specifically, the proportion of patients choosing combined targeted therapy and combined radiotherapy gradually increased as the stage advanced. Among patients at different stages, the proportion of those choosing medium-course chemotherapy was the highest, and the proportion of patients choosing long-course chemotherapy was the highest among those with more advanced stages. Regarding the gross changes, imaging changes, and TRG results after neoadjuvant treatment in the patients at different preoperative stages, there were statistically significant differences in the overall comparison among patients with stage Ⅱ, Ⅲ, and Ⅳ rectal cancer (H=7.860, P=0.020; H=9.845, P=0.007; H=6.680, P=0.035). The proportion of partial response was the highest across all response metrics (macroscopic, radiographic, and TRG) in each stage. Notably, stage Ⅱ patients demonstrated the highest rate of complete response. For TRG evaluation, grade 2 (TRG2) was the most common outcome across all stages. ConclusionsData analysis from DACCA reveals that patients with advanced stages are more likely to choose chemotherapy combined with targeted therapy or radiotherapy, and had a higher proportion of intermediate range chemotherapy and the intensity of neoadjuvant chemotherapy is stronger. In terms of neoadjuvant treatment effects, the earlier the staging, the better the gross and imaging changes, and the lower the TRG level.
ObjectiveTo analyze the relation between educational level of patients with colorectal cancer (CRC) and decision-making and curative effect of neoadjuvant therapy (NAT) in the current version of the Database from Colorectal Cancer (DACCA). MethodsThe eligible CRC patients were collected from June 29, 2022 updated DACCA according to the screening criteria and were assigned into 4 groups according to their educational level, namely, uneducated, primary educated, secondary educated, and tertiary educated. The differences in NAT decision-making, cancer marker change, symptomatic change, gross change, imaging change, and tumor regression grade (TRG) among the CRC patients with different educational levels were compared. ResultsA total of 2 816 data that met the screening criteria were collected, 138 of whom were uneducated, 777 of whom were primary educated, 1 414 of whom were secondary educated, and 487 of whom were tertiary educated. The analysis results revealed that the difference in the composition ratio of patients choosing NAT regimens by educational level was statistically significant (χ2=30.937, P<0.001), which was reflected that the composition ratio of choosing a simple chemotherapy regimen in the uneducated CRC patients was highest, while which of choosing combined targeted therapy regimen in the tertiary educated CRC patients was highest. In terms of treatment outcomes, the composition ratios of changes in cancer markers (H=4.795, P=0.187), symptoms (H=1.722, P=0.632), gross (H=2.524, P=0.471), imaging (H=2.843, P=0.416), and TRG (H=2.346, P=0.504) had no statistical differences. ConclusionsThrough data analysis in DACCA, it is found that the educational level of patients with CRC can affect the choice of NAT scheme. However, it is not found that the educational level is related to the changes in the curative effect of patients with CRC before and after NAT, and further analysis is needed to determine the reasons for this.
Objective To establish a predictive model for long-term tumor-specific survival after surgery for patients with intermediate to advanced medullary thyroid cancer (MTC) based on American Joint Committee on Cancer (AJCC) TNM staging, by using the Surveillance, Epidemiology, and End Results (SEER) Database. Methods The data of 692 patients with intermediate to advanced MTC who underwent total thyroidectomy and cervical lymph node dissection registered in the SEER database during 2004–2017 were extracted and screened, and were randomly divided into 484 cases in the modeling group and 208 cases in the validation group according to 7∶3. Cox proportional hazard regression was used to screen predictors of tumor-specific survival after surgery for intermediate to advanced stage MTC and to develop a Nomogram model. The accuracy and usefulness of the model were tested by using the consistency index (C-index), calibration curve, time-dependent ROC curve and decision curve analysis (DSA). Results In the modeling group, the multivariate Cox proportional hazard regression model indicated that the factors affecting tumor-specific survival after surgery in patients with intermediate to advanced MTC were AJCC TNM staging, age, lymph node ratio (LNR), and tumor diameter, and the Nomogram model was developed based on these results. The modeling group had a C-index of 0.827 and its area under the 5-year and 10-year time-dependent ROC curves were 0.865 [95%CI (0.817, 0.913)], 0.845 [95%CI (0.787, 0.904)], respectively, and the validation group had a C-index of 0.866 and its area under the 5-year and 10-year time-dependent ROC curves were 0.866 [95%CI (0.798, 0.935)] and 0.923 [95%CI (0.863, 0.983)], respectively. Good agreement between the model-predicted 5- and 10-year tumor-specific survival rates and the actual 5- and 10-year tumor-specific survival rates were showed in both the modeling and validation groups. Based on the DCA curve, the new model based on AJCC TNM staging was developed with a significant advantage over the former model containing only AJCC TNM staging in terms of net benefits obtained by patients at 5 years and 10 years after surgery. Conclusion The prognostic model based on AJCC TNM staging for predicting tumor-specific survival after surgery for intermediate to advanced MTC established in this study has good predictive effect and practicality, which can help guide personalized, precise and comprehensive treatment decisions and can be used in clinical practice.
ObjectiveTo 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). MethodsThe selected updated DACCA database as of June 29, 2022 was used for this study. The included patients were assigned into 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 were stratified by pTNM stage. ResultsA total of 1 974 patients 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 higher 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 higher 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 stage found that, for the patients with pTNM Ⅲ stage, the 5- and 10-year cumulative overall survival rates of the intellectual group were higher than those of the manual group (94.0% vs. 82.3%, P<0.001; 67.1% vs. 43.7%, P=0.014), simultaneous the 5- and 10-year cumulative disease-specific survival rates 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 Ⅱ stage , it was found that the the 10-year cumulative disease-specific survival rate of the intellectual group was higher than that of the manual group (93.5% vs. 78.7%, P=0.009).ConclusionsFrom the analysis results of this study, occupation might be related to long-term prognosis in CRC 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 marked in the patients with pTNM Ⅱ and Ⅲ stages, but it needs to be autious and objective.