Quality management in rectal carcinoma: what is feasible?

Int J Colorectal Dis. 2009 Aug;24(8):931-42. doi: 10.1007/s00384-009-0736-9. Epub 2009 Jun 2.

Abstract

Purpose: A cohort study was carried out to analyse quality indicators in the diagnosis and treatment of rectal carcinoma.

Methods: A total of 2,470 patients with rectal carcinoma treated between 1985 and 2007 at the Department of Surgery, University of Erlangen, were analysed and compared within four time intervals.

Results: Most of the indicators analysed from 2004 to 2007 fulfilled the defined target values. The indicators for process quality of surgical treatment and the surrogate indicators of outcome quality in surgery showed excellent results. Comparing this to previous data, it displays the new developments such as introduction of multimodal treatment for high-risk patients. While the rate of locoregional recurrences decreased, no significant improvement in survival was found.

Conclusions: Careful analysis of quality indicators is important for both quality management and comparison of treatment results. The progress in diagnosis and treatment requires a continuous update of definitions and target values.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma / diagnosis*
  • Carcinoma / mortality
  • Carcinoma / therapy*
  • Chemotherapy, Adjuvant / standards
  • Digestive System Surgical Procedures / adverse effects
  • Digestive System Surgical Procedures / mortality
  • Digestive System Surgical Procedures / standards*
  • Feasibility Studies
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoadjuvant Therapy / standards
  • Neoplasm Recurrence, Local
  • Outcome and Process Assessment, Health Care / standards*
  • Prospective Studies
  • Quality Indicators, Health Care / standards*
  • Radiotherapy, Adjuvant / standards
  • Rectal Neoplasms / diagnosis*
  • Rectal Neoplasms / mortality
  • Rectal Neoplasms / therapy*
  • Registries
  • Risk Assessment
  • Time Factors
  • Treatment Outcome
  • Young Adult