A clinical rule-based indicator to identify recurrence of colorectal cancer after curative resection using linked routinely collected national data

IF 3 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2026-02-01 Epub Date: 2025-11-21 DOI:10.1016/j.canep.2025.102962

Orouba Almilaji , Linda Sharples , Ajay Aggarwal , David Cromwell , Kieran Horgan , Michael Braun , Robert Arnott , Julie Nossiter , Angela Kuryba , Alexandra Lewin , Thomas Cowling , Jan Van Der Meulen , Kate Walker

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引用次数: 0

Abstract

Background

Cancer recurrence is under-recorded in most national cancer registries. We developed and validated a clinical rule-based indicator to identify recurrence after curative major resection in patients with non-metastatic colorectal cancer (CRC), based on national routinely collected administrative hospital records and chemotherapy and radiotherapy datasets.

Methods

Recurrence was defined as the cancer becoming clinically detectable again after a period of “remission” (nine months to five years after curative major resection). 34,984 CRC patients aged 18–75 years undergoing curative major resection for non-metastatic disease diagnosed between August 2014 and September 2019 in the English Cancer Registry were identified and linked to records of outpatient visits and admissions in English administrative hospital data and to chemotherapy and radiotherapy datasets. The indicator was developed with a panel of surgical and oncological experts, based on relevant diagnosis (ICD-10), procedure (OPCS-4), and administrative codes.

Results

Of the 34,984 patients, the indicator identified 6556 (18.7 %) as having recurrence. 6173 (94.2 %) of which could be identified using administrative hospital data of admitted patients alone. Recurrence was found in a greater proportion of rectal cancer patients, and in those with more advanced T stage and N stage, and higher cancer grade. Overall and recurrence-free five-year survival from surgery was 88.7 % and 77.4 %, respectively. Two-year overall survival after recurrence was 63.9 %. 135 (82.8 %) of the 163 patients who self-reported recurrence in a national patient experience survey, and 1412 (95.2 %) of the 1483 patients with reported recurrence/progression in Cancer Registry data had recurrence defined by the developed indicator.

Conclusions

The validity of the CRC recurrence indicator was supported by observed associations with tumour characteristics, self-reported recurrence, and poor overall survival in patients with recurrence. This indicator can be used in research and service evaluation, to overcome the problem of incomplete cancer recurrence recording in most national cancer registries.

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一个临床规则为基础的指标，以确定结肠直肠癌治愈性切除后复发使用链接常规收集的国家数据

背景：在大多数国家癌症登记处，癌症复发率记录不足。基于国家常规收集的行政医院记录和化疗和放疗数据集，我们开发并验证了一种基于临床规则的指标，用于识别非转移性结直肠癌（CRC）患者治愈性大切除后的复发。方法复发定义为肿瘤在“缓解期”（治愈性大切除后9个月至5年）后再次被临床检测到。在2014年8月至2019年9月期间，在英国癌症登记处发现了34,984名年龄在18-75岁之间因非转移性疾病接受治疗性大切除的结直肠癌患者，并将其与英国行政医院数据中的门诊就诊和入院记录以及化疗和放疗数据集联系起来。该指标是由外科和肿瘤学专家小组根据相关诊断（ICD-10）、程序（OPCS-4）和行政法规制定的。结果在34,984例患者中，该指标确定6556例（18.7 %）复发。其中6173例（94.2 %）可以单独使用住院患者的医院管理数据识别。直肠癌患者复发率较高，T期和N期越晚期，肿瘤分级越高。手术后总生存率和无复发生存率分别为88.7% %和77.4% %。复发后两年总生存率为63.9 %。在一项全国患者经历调查中，163名自我报告复发的患者中有135名（82.8 %），而在癌症登记处数据中报告复发/进展的1483名患者中，1412名（95.2% %）的复发由所制定的指标定义。结论CRC复发指标的有效性与肿瘤特征、自我报告的复发以及复发患者较差的总生存期之间的相关性得到了支持。该指标可用于研究和服务评估，以克服大多数国家癌症登记处癌症复发记录不完整的问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.