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Volume 7, Issue 4 (Suppl)

J Clin Exp Pathol, an open access journal

ISSN: 2161-0681

Euro Pathology 2017

August 02-03, 2017

EUROPEAN PATHOLOGY CONGRESS

August 02-03, 2017 Milan, Italy

Improving quality of colorectal cancer care: Multidisciplinary collaboration on clinical auditing and

outcomes research

Nicoine van Leersum

1,2

Dutch Institute for Clinical auditing, Netherlands

Leiden University Medical Centre, Netherlands

he Circumferential Resection Margin (CRM) is a significant prognostic factor for local recurrence, distant metastasis, and

survival after rectal cancer surgery.Therefore, availability of this parameter is essential. Although the Dutch total mesorectal

excision trial raised awareness about CRM in the late 1990s, quality assurance on pathologic reporting was not available until

the Dutch Surgical Colorectal Audit (DSCA) started in 2009. The present study describes the rates of CRM reporting and

involvement since the start of the DSCA and analyzes whether improvement of these parameters can be attributed to the audit.

Data from the DSCA (2009-2013) were analyzed. A total of 12,669 patients were included for analysis. The mean percentage

of patients with a reported CRM increased from 52.7% to 94.2% (2009-2013) and inters hospital variation decreased. The

percentage of patients with CRM involvement decreased from 14.2% to 5.6%. Low hospital volume (<20 cases/year) was

independently associated with a higher risk of CRM involvement (OR=1.54; 95% CI: 1.12-2.11). The APE was associated

with a slight, non-significant, increased risk of CRM involvement [odds ratio (OR)=1.33; confidence interval (CI)=0.93-

1.90]. Absolute percentages of CRM involvement were 8% and 12% after LAR and APE. In multivariable analysis, the year

of DSCA registration remained a significant predictor of CRM involvement. After the introduction of the DSCA, a dramatic

improvement in CRM reporting and a major decrease of CRM involvement after rectal cancer surgery have occurred. This

study suggests that a national quality assurance program has been the driving force behind these achievements.

J Clin Exp Pathol 2017, 7:4(Suppl)

DOI: 10.4172/2161-0681-C1-038