Objective:The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer.However,for Chinese patients,there is limited information on the propor...Objective:The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer.However,for Chinese patients,there is limited information on the proportion of cases at each site and the related features.In this study,we explored the location,distribution and other features of colorectal cancers at each anatomic site in Chinese patients.Methods:We conducted a hospital-based study using hospitalization summary reports from 10 Peking University-affiliated hospitals from 2014 to 2018;the reports covered a total of 2,097,347 hospitalizations.Incident cases were chosen as the study population,and their epidemiological features were further analyzed.Results:A total of 20,739 colorectal cancer patients were identified.Rectum was the most common location(48.3%)of the cancer,whereas the proportions of patients with distal and proximal colon cancer were 24.5%and18.6%,respectively.Patients with rectal cancer were predominantly male and were the youngest for all anatomical sites(each P<0.001).The highest proportion of emergency admissions,the longest hospital stays and the highest hospitalization costs were found in patients with proximal colon cancer(each P<0.001).The proximal colon cancer subgroup included the highest proportions of patients with medical histories of cholecystectomy,cholecystolithiasis and/or gallbladder polyps and appendectomy(P=0.009,P<0.001 and P<0.001,respectively).The distal colon cancer subgroup included the highest proportions of patients with medical histories of diabetes and hypertension(P<0.001,respectively).Conclusions:The patterns of colorectal cancer observed in this study differ from those reported for Western patients and show a significantly higher proportion of patients with rectal cancer.Different epidemiological features were also found based on anatomic sites.Further studies based on tumor location should be conducted to facilitate more accurate screening and treatment.展开更多
Background:The aims of this study were to evaluate the prognostic ability of the neoadjuvant rectal(NAR)score and to develop and validate a nomogram based on the NAR for patients with locally advanced rectal cancer(LA...Background:The aims of this study were to evaluate the prognostic ability of the neoadjuvant rectal(NAR)score and to develop and validate a nomogram based on the NAR for patients with locally advanced rectal cancer(LARC)treated with neoadjuvant chemoradiotherapy(nCRT).Methods:In total,307 patients,including 230 patients from the primary cohort and 77 from the external cohort,were enrolled across the two centers.The associations of the NAR score with the tumor response,tumor control,and clinicopathological parameters were analyzed.Survival analysis was performed in the primary and external cohorts using Kaplan‒Meier curves.Univariate and multivariate analyses were performed to evaluate the prognostic factors.The NAR-based nomogram was developed in the primary cohort and validated in the external cohort using the concordance index(C-index),calibration plots,and decision curve analyses(DCAs).Results:Kaplan‒Meier survival analysis revealed that the disease-free survival(DFS)and overall survival(OS)of the NAR>16 group were significantly lower than those of the NAR≤16 group(p<0.001).Multivariate Cox regression analysis identified the NAR score as an independent prognostic factor for both DFS(hazard ratio[HR]=2.484,95%confidence interval[CI]:1.159−5.323,p=0.019)and OS(HR=4.633,95%CI:1.076−19.941,p=0.04).Calibration plots and DCAs showed that NARbased nomograms for DFS and OS were consistent and useful in clinical practice.Moreover,the C-indexes of the NAR-based nomograms were better than those of the other variables in both the primary and external cohorts.Conclusion:Our study validates the prognostic role of the NAR score for DFS and OS.The NAR-based nomogram for OS could accurately predict the outcome of LARC patients by stratifying the risk score accordingly.展开更多
基金supported by grants from the National Natural Science Foundation of China(No.81972702 and No.91959110)national multidisciplinary cooperative diagnosis and treatment capacity building project for major diseases:comprehensive diagnosis and treatment of gastrointestinal tumors,National Health and Family Planning Commission Foundation of China(No.2020YB57)“Clinical Medicine+X”Foundation of Peking University(No.PKU2021LCXQ001)。
文摘Objective:The clinical and biological characteristics of colorectal cancer have been found to differ depending on the anatomic site of the cancer.However,for Chinese patients,there is limited information on the proportion of cases at each site and the related features.In this study,we explored the location,distribution and other features of colorectal cancers at each anatomic site in Chinese patients.Methods:We conducted a hospital-based study using hospitalization summary reports from 10 Peking University-affiliated hospitals from 2014 to 2018;the reports covered a total of 2,097,347 hospitalizations.Incident cases were chosen as the study population,and their epidemiological features were further analyzed.Results:A total of 20,739 colorectal cancer patients were identified.Rectum was the most common location(48.3%)of the cancer,whereas the proportions of patients with distal and proximal colon cancer were 24.5%and18.6%,respectively.Patients with rectal cancer were predominantly male and were the youngest for all anatomical sites(each P<0.001).The highest proportion of emergency admissions,the longest hospital stays and the highest hospitalization costs were found in patients with proximal colon cancer(each P<0.001).The proximal colon cancer subgroup included the highest proportions of patients with medical histories of cholecystectomy,cholecystolithiasis and/or gallbladder polyps and appendectomy(P=0.009,P<0.001 and P<0.001,respectively).The distal colon cancer subgroup included the highest proportions of patients with medical histories of diabetes and hypertension(P<0.001,respectively).Conclusions:The patterns of colorectal cancer observed in this study differ from those reported for Western patients and show a significantly higher proportion of patients with rectal cancer.Different epidemiological features were also found based on anatomic sites.Further studies based on tumor location should be conducted to facilitate more accurate screening and treatment.
基金This work was supported by grants from Peking University Third Hospital‖United‐Imaging Research Institution Intelligential Imaging Joint Research&Development Centre Foundation(H79462‐07)the National Natural Science Foundation of China(62173005)+2 种基金the Natural Science Foundation of Beijing(7204324)the special fund of the National Clinical Key Specialty Construction Program,China(2021)the National multidisciplinary cooperative diagnosis and treatment capacity building project for major diseases:comprehensive diagnosis and treatment of gastrointestinal tumors.
文摘Background:The aims of this study were to evaluate the prognostic ability of the neoadjuvant rectal(NAR)score and to develop and validate a nomogram based on the NAR for patients with locally advanced rectal cancer(LARC)treated with neoadjuvant chemoradiotherapy(nCRT).Methods:In total,307 patients,including 230 patients from the primary cohort and 77 from the external cohort,were enrolled across the two centers.The associations of the NAR score with the tumor response,tumor control,and clinicopathological parameters were analyzed.Survival analysis was performed in the primary and external cohorts using Kaplan‒Meier curves.Univariate and multivariate analyses were performed to evaluate the prognostic factors.The NAR-based nomogram was developed in the primary cohort and validated in the external cohort using the concordance index(C-index),calibration plots,and decision curve analyses(DCAs).Results:Kaplan‒Meier survival analysis revealed that the disease-free survival(DFS)and overall survival(OS)of the NAR>16 group were significantly lower than those of the NAR≤16 group(p<0.001).Multivariate Cox regression analysis identified the NAR score as an independent prognostic factor for both DFS(hazard ratio[HR]=2.484,95%confidence interval[CI]:1.159−5.323,p=0.019)and OS(HR=4.633,95%CI:1.076−19.941,p=0.04).Calibration plots and DCAs showed that NARbased nomograms for DFS and OS were consistent and useful in clinical practice.Moreover,the C-indexes of the NAR-based nomograms were better than those of the other variables in both the primary and external cohorts.Conclusion:Our study validates the prognostic role of the NAR score for DFS and OS.The NAR-based nomogram for OS could accurately predict the outcome of LARC patients by stratifying the risk score accordingly.
