The current status of treatment for colorectal cancer in China

Zhang, Yumei; Chen, Zhiyu; Li, Jin

doi:10.1097/md.0000000000008242

Cited by 129 publications

(103 citation statements)

References 61 publications

(69 reference statements)

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“…Moreover, the current study found that a small proportion of patients treated with FOLFOX in the first-line setting either shifted to capecitabine/S1 or continued to use FOLFOX in the second-line setting, which was controversial to the guidelines for standard of care [37]. This gap between clinical practice and guidelines may be due to patients' preference, economic status, physicians' decisions [37][38][39]. Implementing education program and providing training courses to physicians as well as raising the public awareness of CRC might help with the treatment decisionmaking.…”

Section: Discussionmentioning

confidence: 71%

“…This may imply poor treatment outcomes of targeted therapy in late lines, and a lack of consensus on both the timing and options for third-line treatment during the study period (2011)(2012)(2013)(2014)(2015)(2016). Moreover, the current study found that a small proportion of patients treated with FOLFOX in the first-line setting either shifted to capecitabine/S1 or continued to use FOLFOX in the second-line setting, which was controversial to the guidelines for standard of care [37]. This gap between clinical practice and guidelines may be due to patients' preference, economic status, physicians' decisions [37][38][39].…”

Section: Discussionmentioning

confidence: 74%

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Disease characteristics and treatment patterns of Chinese patients with metastatic colorectal cancer: a retrospective study using medical records from China

Wang

Zhu

et al. 2020

BMC Cancer

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Background: Colorectal cancer (CRC) is the third most prevalent cancer in China but few large-scale studies were conducted to understand CRC patients. The current study is aimed to gain a real-world perspectives of CRC patients in China.Methods: Using electronic medical records of sampled patients between 2011 and 2016 from 12 hospitals in China, a retrospective cohort study was conducted to describe demographics and disease prognosis of CRC patients, and examine treatment sequences among metastatic CRC (mCRC) patients. Descriptive, comparative and survival analyses were conducted. Results: Among mCRC patients (3878/8136, 48%), the fluorouracil, leucovorin, and oxaliplatin (FOLFOX) and other oxaliplatin-based regimens were the most widely-used first-line treatment (42%). Fluorouracil, leucovorin, irinotecan (FOLFIRI) and other irinotecan-based regimens dominated the second-line (40%). There was no a dominated regimen for the third-line. The proportion of patients receiving chemotherapy with targeted biologics increased from less than 20% for the first-and second-lines to 34% for the third-line (p < 0.001). The most common sequence from first-to second-line was from FOLFOX and other oxaliplatin-based regimens to FOLFIRI and other irinotecan-based regimens (286/1200, 24%). Conclusions:Our findings reflected a lack of consensus on the choice of third-line therapy and limited available options in China. It is evident o continue promoting early CRC diagnosis and to increase the accessibility of treatment options for mCRC patients. As the only nationwide large-scale study among CRC and mCRC patients before more biologics became available in China, our results can also be used as the baseline to assess treatment pattern changes before and after more third-line treatment were approved and covered into the National Health Insurance Plan in China between 2017 and 2018.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 74%

Disease characteristics and treatment patterns of Chinese patients with metastatic colorectal cancer: a retrospective study using medical records from China

Wang

Zhu

et al. 2020

BMC Cancer

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“…Colorectal cancer is the third leading cause of cancer-associated mortality globally (1,2). Although the majority of patients with CRC are treated using surgery combined with chemotherapy, local recurrence and remote metastases following therapy often influence their survival rate (30). At present, there is a lack of effective biomarkers for CRC recurrence.…”

Section: Discussionmentioning

confidence: 99%

IRF1 association with tumor immune microenvironment and use as a diagnostic biomarker for colorectal cancer recurrence

Zhang

Yan

2020

Oncol Lett

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Colorectal cancer (CRC) is considered to be one of the most lethal cancer types globally, and its recurrence is a major treatment challenge. Identifying the factors involved when determining the risk of CRC recurrence is required to improve personalized therapy for patients with CRC. Based on the GSE39582 dataset, the present study demonstrated that a higher ratio of M1 macrophages and activated memory CD4 + T cells indicated a better recurrence-free survival (RFS) time for CRC, using CIBERSORT and Pearson's correlation analysis. Through weighted correlation network analysis (WGCNA), an immune-associated module was identified that was significantly positively correlated with the ratio of M1 macrophages and activated memory CD4 + T cells. In this module, using WGCNA and a protein-protein interaction network, interferon regulatory factor 1 (IRF1), chemokine ligand 5, ubiquitin/ISG15-conjugating enzyme E2 L6, guanylate binding protein 1 and interleukin 2 receptor subunit beta were identified as hub genes. Among these genes, univariate Cox and multivariate Cox analysis revealed that IRF1 may be a potential diagnostic biomarker for RFS in patients with CRC. This was further validated using The Cancer Genome Atlas data. Gene set enrichment analysis demonstrated that IRF1 influenced the genes and pathways that are associated with immune cell recruitment and activation. Additionally, the DNA methylation of cg27587780 and cg15375424 CpG sites in the IRF1 gene region was indicated to be negatively correlated with IRF1 mRNA expression and positively correlated with the recurrence of CRC. Collectively, the results of the present study demonstrated that IRF1 may be a potential diagnostic biomarker for RFS in patients with CRC.

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“…Colorectal carcinoma is the third most common malignant tumor worldwide, with surgical resection being the only effective treatment currently available. 1,2 Despite important advances in surgical techniques, the overall rate of complications remains high, at around 30%. 3 Postoperative complications are associated with increased treatment costs, prolonged hospital stay, delayed adjuvant chemotherapy, increased risk of recurrence, and a detrimental impact on survival.…”

Section: Introductionmentioning

confidence: 99%

<p>Usefulness of Inflammation-Based Prognostic Scores for Predicting the Risk of Complications After Radical Resection of Colorectal Carcinoma</p>

Man¹,

Lin²,

Liu³

et al. 2020

CMAR

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These authors contributed equally to this workPurpose: We aimed to investigate the value of inflammation-based prognostic scores for predicting early complications after radical surgery for colorectal carcinoma. Methods: We retrospectively analyzed data of 154 patients who underwent elective resection of colorectal carcinoma between January 2017 and December 2018 at Beijing Friendship Hospital. Univariate, multivariate, and receiver operating characteristic curve analyses were conducted. As inflammation indices, we evaluated the preoperative modified Glasgow Prognostic Score (GPS), as well as the C-reactive protein/albumin ratio (CAR), postoperative GPS, and C-reactive protein levels on postoperative day 3 (POD3). Results: Within 30 days postoperatively, complications occurred in 80 patients (51.9%). And high levels of preoperative mGPS (P=0.002), preoperative CAR (P=0.019), POD3 CAR (P<0.001) and POD3 poGPS (P<0.001) can significantly affect postoperative complications after surgery for colorectal cancer, with CRP on POD3 (odds ratio, 1.015; 95% confidence interval, 1.006-1.024; P=0.001) as independent risk factors. Among all inflammation-based indicators, POD3 CAR had the highest area under the curve (0.711) and positive predictive value (83.2%). Higher CAR (≥2.6) on POD3 was associated with a higher rate of complications (92.9% vs 36.6%, P<0.001), especially of infectious nature (54.8% vs 16.1%, P<0.001). Conclusion: CAR≥2.6 on POD3 reflects sustained systemic inflammation and represents a useful predictor of complications after surgery for colorectal carcinoma, facilitating early detection, timely intervention, and enhanced recovery.

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The current status of treatment for colorectal cancer in China

Cited by 129 publications

References 61 publications

Disease characteristics and treatment patterns of Chinese patients with metastatic colorectal cancer: a retrospective study using medical records from China

Disease characteristics and treatment patterns of Chinese patients with metastatic colorectal cancer: a retrospective study using medical records from China

IRF1 association with tumor immune microenvironment and use as a diagnostic biomarker for colorectal cancer recurrence

<p>Usefulness of Inflammation-Based Prognostic Scores for Predicting the Risk of Complications After Radical Resection of Colorectal Carcinoma</p>

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