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

Ruihua Xu,Yongzhan Nie,Xiaoyan Lin,Qi Li,Yun Chen,Lingjun Zhu,Ning Wang,Wei Wang,Lin Shen,Weijia Fang,Qingchuan Zhao,Dong Ma,Cike Peng,Hongyan Li,Xiaohong Cai,Bo Zhu,Honghao Fang

doi:10.1186/s12885-020-6557-5

Abstract

BackgroundColorectal 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.MethodsUsing 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.ResultsAmong 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%).ConclusionsOur 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.

Highlights

Colorectal cancer (CRC) is the third most prevalent cancer in China but few large-scale studies were conducted to understand CRC patients
The National Central Cancer Registry (NCCR) showed that prognosis of CRC was much poorer in China compared with developed countries [5]
Patient flow Data of 8246 CRC patients identified from the selected hospitals during the study period were extracted and screened

Summary

Introduction

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. Colorectal cancer (CRC) is the third most common cancer in China, with 370,000 new cases in year 2014, comprising 9.73% of all cancers [1]. CRC is one of the leading causes of cancer deaths in China. There has been evidence that a diet high in fats and low in fruits and vegetables increases the risk of developing CRC [3, 4]. Because of the rapidly aging population and in the increasing fat intake in China, CRC incidence is expected to continue increasing. The National Central Cancer Registry (NCCR) showed that prognosis of CRC was much poorer in China compared with developed countries [5]

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Discussion

Conclusion