List of colorectal cancer surgery indicators prioritized by the expert panel
| Type of indicator | Level of measurement, indicator | ||
|---|---|---|---|
| Provincial/regional | Hospital/team | Surgeon/individual provider | |
| Access | — | — | — |
| Outcome | 5-yr and adjusted 5-yr overall survival rate for rectal cancer by stage and for colon cancer by stage | — | Proportion of in-hospital mortality or mortality within 30 d of non-emergent colon or rectal cancer surgery Rate of local recurrence for patients who have had rectal cancer surgery, by stage, and for patients who have had colon cancer surgery, by stage Proportion of patients undergoing surgery for rectal cancer who experience an anastomotic leak |
| Appropriateness of diagnosis, staging and assessment | Proportion of colon and rectal carcinomas detected by screening | — | Proportion of patients undergoing surgery for colon or rectal cancer who have preoperative complete large-bowel imaging (colonoscopy or barium enema plus sigmoidoscopy) 3 mo before surgery or within 6 mo after surgery Proportion of patients undergoing surgery for rectal cancer who have preoperative imaging of the pelvis with CT, MRI and/or TRUS Proportion of patients undergoing surgery for colon or rectal cancer who have preoperative imaging of the liver with ultrasonography, CT or MRI |
| Appropriateness of surgery | — | — | Proportion of patients with rectal cancer undergoing surgery with a positive distal margin Proportion of patients who have undergone rectal cancer surgery whose operative report includes mention of total mesorectal type dissection, location of tumour, extent of resection (en bloc removal and margins), degree of nerve preservation, extent of lymphadenectomy |
| Appropriateness of adjuvant therapy | Proportion of patients with known or suspected rectal cancer who see a radiation oncologist preoperatively or whose cancer is stage II or III and see a radiation oncologist within 8 wk of surgery Proportion of patients with rectal cancer who see a medical oncologist preoperatively or whose cancer is stage II or III and see a medical oncologist within 8 wk of surgery | — | — |
| Appropriateness of pathology | — | Proportion of patients who have undergone colon or rectal cancer surgery whose pathology report includes margin status (distal, radial) Proportion of patients who have undergone colon or rectal cancer surgery whose pathology report indicates number of lymph nodes examined and the number of positive lymph nodes | — |
| Appropriateness of follow-up | — | — | Proportion of patients with colon cancer who undergo surveillance colonoscopy within 1 yr after surgery |
Note: CT = computed tomography; MRI = magnetic resonance imaging; TRUS = transrectal ultrasonography.