ObjectiveTo analyze the characteristics of colorectal cancer surgery in the current version of Database from Colorectal Cancer (DACCA).MethodsThe DACCA version selected for this data analysis was the updated version on April 16th, 2020. The data items included timing of operation, types of operative procedure, radical resection level of operation, patient’s wish of anus-reserving, types of stomy, date of stoma closure, surgical approaches, extended resection, and type of intersphincteric resection (ISR). The data item interval of stoma closure was added, and the selected data items were statistically analyzed.ResultsThe total number of medical records (data rows) that met the criteria was 11 757, including 2 729 valid data on the timing of operation (23.2%), 11 389 valid data on the types of operative procedure (96.9%), 4 255 valid data on the radical resection level of operation (36.2%), 3 803 valid data on patient’s wish of anus-reserving (32.3%), 4 377 valid data on types of stomy (37.2%), 989 valid data on date of stoma closure (8.4%), 4 418 valid data on surgical approaches (37.6%), 3 941 valid data on extended resection (33.5%), and 1 156 valid data on type of ISR (9.8%). In the timing of operation, the most cases were performed immediately after discovery or neoadjuvant completion (915, 33.5%). In types of operative procedure, ultra low anterior resection (ULAR), right hemicolectomy (RHC), and low anterior resection (LAR) were the most, including 1 986 (17.4%), 1 412 (12.4%), and 1 041 (9.1%) lines. Respectively in the colon and rectal cancer surgery, the proportion of RHC (50.0%) and ULAR (26.0%) was the highest, with 172 (26.1%) and 815 (27.9%) extended resection. In ISR surgery the majority was ISR-2 (741, 64.1%). In radical resection level of operation, the number of R0 was the largest with 2 575 (60.5%) lines. In patient’s wish of anus-reserving, positive and rational were the most with 1 811 (47.6%) and 1 440 (37.9%) lines, respectively. And in types of stomy, there were 2 628 lines (60.0%) without stoma and 1 749 cases (40.0%) with stoma, among which the most lines were right lower ileum stoma (612, 35.0%). The minimum value, maximum value, and median value of interval of stoma closure were 0 d, 2 678 d and 112 d. The linear regression prediction of date of stoma closure by year was \begin{document}${\hat {y}} $\end{document}=9.234 3x+22.394 (R2=0.2928, P=0.07). In the surgical approaches, the majority was standard with 3 182 (72.0%) lines.ConclusionsIn the DACCA, rectal cancer surgery is still the majority, and ULAR is the most type. The application of extended resection in both colon and rectal cancer has important significance. The data related to stoma are diversified and need to be further studied.
The hospital information structure, which is made up of various medical business systems, is suffering from the problems of the "information isolated island". Medical business systems in the hospital are mutually isomerous and difficult to become a whole. How to realize the internal barrier-free interaction of the patients effective medical information in the hospital and further to complete the area sharing of patients longitudinal diagnosis and treatment information has become a question having to be solved urgently in the process of healthcare informatization. Based on the HL7 standard, this paper refers to the IHE technical framework, expounds the overall structure of the interaction in the hospital internal and area sharing of medical information with the medical information exchange platform. The paper also gives the details of the whole process of the complete display of the discrete patient health information using Portal technology, which is saved in the business systems in different hospitals. It interacts internally through the information exchange platform and at last stores the information in the regional cinical data repository (CDR).
ObjectiveTo describe the characteristics of colorectal cancer surgical procedures in the West China Colorectal Cancer Database (Database from Colorectal Cancer, DACCA).MethodWe used the form of text description.ResultsThe related content modules of DACCA operation in West China, included operative type, radical resection level, anus preservation, stoma type, the date of closure, surgical approach, expansive resection, intersphincteric resection (ISR), etc. were elaborated. The data label related method corresponding to each item in the database and the structured method required in the corresponding big data application stage were elaborated, and the error correction precautions of all classified items were described.ConclusionsIn the DACCA database, there are more detailed classification for the radical treatment of colorectal cancer. The application of expanded surgery is of great significance for both colon cancer and rectal cancer; stoma-related data has diversified data characteristics, which will provides standards and basis for clinical application of DACCA, and also provides experience reference for other colleagues who want to build colorectal cancer database.
ObjectiveTo analyze the impact of the residence of patients with colorectal cancer (CRC) on surgical characteristics in the current version Database from Colorectal Cancer (DACCA). MethodsAccording to the established screening conditions, the patients with CRC were collected from the updated version of DACCA on January 23, 2023. The analysis indicators enrolled in this study included: the grouping indicator was residence, the surgical characteristic indicators included the surgical timing, surgical nature, expanded resection, intersphincteric resection (ISR) type, patient’s willingness of preserving the anus, and whether preserving the anus. The patients were categorized into three groups based on the residence: inside Chengdu City, outside Chengdu City within Sichuan Province, and outside Sichuan Province. The surgical characteristic indicators of patients with CRC from different residences were comparatively analyzed. ResultsA total of 6 832 analyzable data rows were enrolled. The results of statistical analysis revealed the following findings: there were no statistical differences in the surgery timing and surgery nature among the patients with colon cancer or rectal cancer from the different residences (Surgery timing: H=1.665, P=0.435; H=4.153, P=0.125. Surgery nature: χ2=1.586, P=0.453; χ2=0.990, P=0.610); For the patients with rectal cancer from the different residences, the distributions of the ISR type (H=0.514, P=0.773), patients’ willingness of preserving the anus (χ2=1.437, P=0.487), and whether preserving the anus (χ2=5.513, P=0.064) had no statistical differences. In addition, although there was no statistical difference in the distribution of expanded resection or not among the patients with rectal cancer in different residences (χ2=2.363, P=0.307), it was found that there was statistical difference in the distribution of enlarged resection or not among the patients with colon cancer in different residences (χ2=17.324, P＜0.001). ConclusionsFrom the data analysis in DACCA, there are not statistical differences in surgical characteristic indicators such as surgical timing, surgical nature, ISR type, patients’ willingness of preserving the anus, and whether preserving the anus among patients with colon or rectal cancer from different residences. However, the proportion of underwent expanded surgery in the colon cancer patients who from outside Sichuan Province as compared with inside Sichuan Province is relatively higher, this suggests that surgical difficulty is more difficult for the patients from outside Sichuan Province.
ObjectiveTo describe the constructive process of follow-up of colorectal cancer part in the Database from Colorectal Cancer (DACCA) in West China Hospital. MethodThe article was described in words. ResultsThe specific concepts of follow-up of colorectal cancer including end-stage of follow-up, survival status, follow-up strategy, follow-up emphasis, follow-up plan, follow-up record using communication tools, follow-up frequency, annual follow-up times, and single follow-up record of the DACCA in the West China Hospital were defined. Then they were detailed for their definition, label, structure, error correction, and update. ConclusionThrough the detailed description of the details of follow-up of colorectal cancer of DACCA in West China Hospital, it provides the standard and basis for the clinical application of DACCA in the future, and provides reference for other peers who wish to build a colorectal cancer database.
Objective To help systematic reviewers select the best Chinese biomedical databases to retrieve relevant trials in Chinese according to comparison of coverage, search feature, English search capabilities, and so on. Methods Four Chinese biomedical databases (CBM, CNKI, VIP and WANFANG) were selected. Data about coverage, search features, records downloading, and presence or lack of English search capabilities were found through their websites. The deadline for data collection was at the end of April 2010. Based on the data collected, the number of journals back to the inaugural issue and indexed cover-to-cover were calculated. Results The average of the indexed journals in 4 databases was about 1 200; the indexed articles were about 4.92 million, and the averages of backdate rate and entire collection rate were 29% and 48%, respectively. CBM indexed fewer articles than CNKI (5 673 316 vs. 5 834 952), but indexed the most journals (1 784, 91%). It provides MeSH searching and more terms than other databases, and has an output of the tagged texts up to 500 records per file. CNKI and WANFANG provide English interfaces, which is convenient for English searching, and CNKI has a function of "Cross-Language Search", which automatically translates English into Chinese. Conclusion CBM is the preferred database for systematic reviewers to retrieve relevant studies in Chinese, while CNKI is recommended for non-Chinese-speaking researchers due to its English interface and “Cross-Language Search” function.
Objective To explore the value of surgical treatment in rectal small cell neuroendocrine carcinoma (RSCC). Method The clinical data of patients with pathologically diagnosed as RSCC from 2000 to 2019 were extracted from the Surveillance, Epidemiology and End Results (SEER) database, to explore the effect of surgical treatment on cancer-specific survival (CSS) and overall survival (OS). Results A total of 348 cases were included with the median follow-up of 8 months (IQR: 3–16 months). Of the 101 patients in the operation group, 84 died (83.2%), including 56 tumor-related deaths (55.4%). Of the 247 patients in the non-operation group, 215 died (87.0%), including 131 tumor-related deaths (53.0%). The estimated 1-year OS of the operation group and the non-operation group were 49.6% and 34.4%, respectively, and the estimated 1-year CSS of those were 62.2% and 49.2%, respectively. There were significant differences between the two groups (both P<0.05). Results of multivariate prognostic analysis by Cox proportional hazard model showed that differentiation, SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for OS, and SEER stage, receiving operative treatment or not, receiving chemotherapy or not, and receiving radiotherapy or not were independent influencing factors for CSS (all P<0.05). The OS [RR=0.61, 95%CI was (0.45, 0.81), P<0.001] and CSS [RR=0.67, 95%CI was (0.47, 0.95), P=0.025] in RSCC patients were significantly improved by surgical treatment. Conclusion Surgical treatment can improve the OS and CSS in RSCC patients.
ObjectiveTo analyze the impact of neoadjuvant regimens on prognosis in patients with rectal cancer in the current version of the Database from Colorectal Cancer (DACCA) database. MethodsPatient information was extracted from the updated version of DACCA on November 24, 2022 according to the established screening criteria, and the following items were analyzed: gender, age, body mass index (BMI), marriage, economic conditions, degree of differentiation, neoadjuvant treatment regimen, and pTNM staging. According to the neoadjuvant treatment regimen, the patients were divided into three groups: chemotherapy group, chemotherapy combined radiotherapy group, and chemotherapy combined targeted therapy group, and the overall survival (OS) and disease-specific survival (DSS) of patients in the three groups were analyzed, and the influencing factors of OS and DSS were analyzed by univariate and multivariate Cox proportional hazard regression models. ResultsAccording to the screening criteria, 1 716 valid data were obtained from the DACCA database, of which 954 (55.6%) were in the chemotherapy group, 332 (19.3%) in the chemotherapy combined radiotherapy group, and 430 (25.1%) in the chemotherapy combined targeted therapy group. The differences in the Kaplan-Merier survival curves of patients with different neoadjuvant regimens for OS and DSS in the three groups were statistically significant (χ2=142.142, P＜0.001; χ2=129.528, P＜0.001). There were significant differences in OS rate and DSS rate between the three groups in 3 years and 5 years (P<0.001). Further comparison of different neoadjuvant therapy groups showed that the OS of the chemotherapy combined targeted therapy group was slightly better than that of the chemotherapy group in 3 years, however, OS and DSS in 5 years were slightly worse than those the chemotherapy group, but the difference were not statistically significant (P>0.05). The OS and DSS of the chemotherapy group and the chemotherapy combined targeted therapy group were better than those of the chemotherapy combined radiotherapy group in 3 years and 5 years, and the differences were statistically significant (P<0.01). The results of multivariate analysis showed that patients’ age, economic conditions, degree of tumor differentiation, new auxiliary scheme and pTNM staging were the influencing factors of OS and DSS. ConclusionNeoadjuvant treatment regimen will affect the long-term survival prognosis of rectal cancer patients.
ObjectiveTo explain in detail hospitalization process management of colorectal cancer as well as its tag and structure of Database from Colorectal Cancer (DACCA) in the West China Hospital.MethodThe article was described in the words.ResultsThe definition and setting of 8 classification items involved in the hospitalization process management from DACCA in the West China Hospital were set. The items were included the date of first out-patient meeting, admitted date, operative date, discharged date, waiting time before the admission, preoperative staying days, total hospital staying days, and manage protocol. The relevant data tag of each item and the structured way needed at the big data application stage were elaborated and the corrective precautions of classification items were described.ConclusionsBased on description about hospitalization process management from DACCA in West China Hospital, it is provided a clinical standard and guidance for analyzing of DACCA in West China Hospital in future. It also could provide enough experiences for construction of colorectal cancer database by staff from same occupation.