Use of a national registry to define a composite quality metric for rectal cancer. Journal Article

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Authors: Tonelli, CM; Kulshrestha, S; Singer, M; Pawlik, TM; Luchette, FA; Abdelsattar, ZM; Baker, MS
Article Title: Use of a national registry to define a composite quality metric for rectal cancer.
Abstract: BACKGROUND: Quality assessment in oncologic surgery has traditionally involved reporting discrete metrics that may be difficult for patients and referring providers to interpret. We define a composite quality metric (CQM) for resection in rectal cancer. METHODS: We queried the National Cancer Database to identify patients undergoing low anterior resection for clinical stage II-III rectal adenocarcinoma between 2010 and 2017. CQM was defined as appropriate neoadjuvant therapy, margin-negative resection, appropriate lymph node assessment, postoperative length of stay (LOS) 75th percentile, and no 30-day readmission or mortality. RESULTS: 19,721 patients met inclusion criteria; 8,083 (41%) had a CQM. The most common reasons for failure to achieve CQM: inadequate node assessment (27%), prolonged LOS (26%). On Cox modeling, CQM (aHR 0.70, 95% CI [0.66, 0.75]) was associated with improved overall survival. CONCLUSION: CQM is independently associated with improved survival in rectal cancer and may be an effective measure of quality.
Journal Title: American Journal of Surgery
ISSN: 1879-1883; 0002-9610
Publisher: Elsevier Inc  
Date Published: 2022