Quality indicators for colorectal cancer surgery and care according to patient-, tumor-, and hospital related factors Full Text
BMC Cancer, 08/09/2012
Mathoulin–Pelissier S et al. – Although some changes in practices may have occurred since this observational study, these findings represent the most recent report on practices in CRC in this region, and offer a useful methodological approach for assessing quality of care. Guideline compliance was high, although several practice variations were highlighted in particular based on some organizational factors such as hospital size or location influence practice variation. These factors should be the focus of any future guideline implementation.Methods
- The authors included 1,206 patients, 825 (68%) with colon and 381 (32%) with rectal cancer, from 53 hospitals.
- For major practices cCompliance was high for (resection, pathology report, LN examination, and chemotherapy use for stage III patients).
- For colon cancer, patients, 26% of stage II patients received adjuvant chemotherapy and 71% of stage III patients.
- 84% of stage US T3T4 rectal cancer patients received pre–operative radiotherapy.
- In For colon cancer patients, factors associated with examination of <=12 LNs were: lower ECOG score, advanced stage and larger hospital volume; factors negatively associated were: left sided tumor location and one hospital district.
- Use of chemotherapy in stage II patients was associated with younger age, advanced stage, emergency setting and care structure (private and location); whereas under–use in stage III patients was associated with advanced age, presence of comorbidities and private hospitals.