Modified Cancer Care Ontario quality-of-care indicators for evaluating outcomes in colorectal cancer treatment (17)
| Indicator | Definition |
|---|---|
| 1. Patients diagnosed by screening | Proportion of patients diagnosed symptom free by any screening method |
| 2. Adequate colon evaluation | Proportion of patients with complete colon imaging (colonoscopy or barium enema + sigmoidoscopy) 3 months before surgery of within 6 months after surgery |
| 3. Preoperative liver imaging (CT, MRI, ultrasonography) | Proportion of patients with complete preoperative imaging of liver with ultrasonography, CT or MRI |
| 4. Preoperative pelvis imaging in patients with rectal cancer (CT, MRI) | Proportion of patients with rectal cancer who had preoperative imaging of the pelvis with CT or MRI |
| 5. Patients with rectal cancer who received NEORT | Proportion of patients with rectal cancer who saw a medical oncologist preoperatively, or of patients with stage II/III rectal cancer who saw a medical oncologist within 8 weeks of surgery or received preoperative radiotherapy |
| 6. Patients with rectal cancer who received NEOCT | Proportion of patients with rectal cancer who saw a radiation oncologist preoperatively, or patients with stage II/III rectal cancer who saw a radiation oncologist within 8 weeks of surgery or received preoperative chemotherapy |
| 7. Completeness of the operative report | Completeness of the surgical report of patients who underwent surgery for rectal cancer; 2 points assigned for each of the following aspects: total mesorectal excision, tumour location, tumour extension, lymphadenectomy, degree of nerve sparing (maximum score possible = 10) |
| 8. Pathology report completeness: lymph nodes | Proportion of patients whose pathology report indicates the number of lymph nodes examined and the number of positive lymph nodes |
| 9. Pathology report completeness: distal and circumferential margin | Proportion of patients whose pathology report indicates distal and circumferential margins quantitatively |
| 10. Pathology report completeness: rectal cancer distal margin ≥ 1 cm | Proportion of patients who underwent surgery for rectal cancer whose distal margin was ≥ 1 cm |
| 11. Anastomotic leak | Proportion of patients who underwent surgery for rectal cancer who experienced anastomotic leak |
| 12. In-hospital/30-day mortality | Death in hospital or within 30 days of discharge after colon or rectal cancer surgery |
| 13. Local recurrence | Proportion of patients with local recurrence within the pelvis confirmed by histologic examination, diagnostic imaging, colonoscopy and/or biopsy at reoperation |
| 14. Survival rate | 3- or 5-year overall survival rate |
| 15. Surveillance colonoscopy | Proportion of patients who underwent surveillance colonoscopy within 1 year after surgery |
CT = computed tomography; MRI = magnetic resonance imaging; NEOCT = neoadjuvant chemotherapy; NEORT = neoadjuvant radiotherapy.