The impact of audit and feedback on nodal harvest in colorectal cancer

Porter, Geoffrey A.; Urquhart, Robin; Bu, Jingyu; Johnson, Paul M.; Grunfeld, Eva

doi:10.1186/1471-2407-11-2

Cited by 24 publications

(17 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Records of chemotherapy or radiation administration can describe dose intensity and completion rates that can be compared with those recommended in RCTs and practice guidelines 73,74 . Pathology records can offer insight into the quality of surgical care and provide data to drive quality improvement 75 . Porter et al 75 used a cancer registry and linked treatment records to evaluate the extent to which an audit and feedback programme led to improved lymph node harvest among patients with colorectal cancer.…”

Section: Quality Of Derived Variablesmentioning

confidence: 99%

“…Pathology records can offer insight into the quality of surgical care and provide data to drive quality improvement 75 . Porter et al 75 used a cancer registry and linked treatment records to evaluate the extent to which an audit and feedback programme led to improved lymph node harvest among patients with colorectal cancer. In LMICs, failure to complete treatment is a major problem for a substantial proportion of patients; RWD can be used to describe the extent of incomplete treatment and offer insights into modifiable factors 76 .…”

Section: Quality Of Derived Variablesmentioning

confidence: 99%

See 1 more Smart Citation

Real-world data: towards achieving the achievable in cancer care

2019

View full text Add to dashboard Cite

The use of data from the real world to address clinical and policy-relevant questions that cannot be answered using data from clinical trials is garnering increased interest. Indeed, data from cancer registries and linked treatment records can provide unique insights into patients, treatments and outcomes in routine oncology practice. In this Review , we explore the quality of real-world data (RWD), provide a framework for the use of RWD and draw attention to the methodological pitfalls inherent to using RWD in studies of comparative effectiveness. Randomized controlled trials and RWD remain complementary forms of medical evidence; studies using RWD should not be used as substitutes for clinical trials. The comparison of outcomes between nonrandomized groups of patients who have received different treatments in routine practice remains problematic. Accordingly , comparative effectiveness studies need to be designed and interpreted very carefully. With due diligence, RWD can be used to identify and close gaps in health care, offering the potential for short-term improvement in health-care systems by enabling them to achieve the achievable.

show abstract

Section: Quality Of Derived Variablesmentioning

confidence: 99%

Section: Quality Of Derived Variablesmentioning

confidence: 99%

Real-world data: towards achieving the achievable in cancer care

2019

View full text Add to dashboard Cite

show abstract

“…Adequate LNH rate was 84.9% in stage II colon cancer of Cleveland Clinic (Cleveland, OH). Adequate LNH rate ranges from 31% to 84.9% in CRCs, and risk factors for poor LNH include early stage CRCs and neoadjuvant concurrent chemoradiotherapy [ 9 - 11 ]. In addition, the rate of adequate LNHs has shown a drastic increase since the National Comprehensive Cancer Network guideline referred to LNH below 12 nodes as a high risk group [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Novel Methods of Lymph Node Evaluation for Predicting the Prognosis of Colorectal Cancer Patients with Inadequate Lymph Node Harvest

et al. 2016

View full text Add to dashboard Cite

PurposeLymph node metastasis is an important factor for predicting the prognosis of colorectal cancer patients. However, approximately 60% of patients do not receive adequate lymph node evaluation (less than 12 lymph nodes). In this study, we identified a more effective tool for predicting the prognosis of patients who received inadequate lymph node evaluation.Materials and MethodsThe number of metastatic lymph nodes, total number of lymph nodes examined, number of negative metastatic lymph nodes (NL), lymph node ratio (LR), and the number of apical lymph nodes (APL) were examined, and the prognostic impact of these parameters was examined in patients with colorectal cancer who underwent surgery from January 2004 to December 2011. In total, 806 people were analyzed retrospectively.ResultsIn comparison of different lymph node analysis methods for rectal cancer patients who did not receive adequate lymph node dissection, the LR showed a significant difference in overall survival (OS) and the APL predicted a significant difference in disease-free survival (DFS). In the case of colon cancer patients who did not receive adequate lymph node dissection, LR predicted a significant difference in DFS and OS, and the APL predicted a significant difference in DFS.ConclusionIf patients did not receive adequate lymph node evaluation, the LR and NL were useful parameters to complement N stage for predicting OS in colon cancer, whereas LR was complementary for rectal cancer. The APL could be used for prediction of DFS in all patients.

show abstract

“…This is due to an insufficient sampling which can lead to an erroneously judged more favorable staging and therefore not subject to the adjuvant therapies that in the more advanced stage can guarantee an improvement in results [39,40].…”

Section: Discussionmentioning

confidence: 99%

Lymph Node Ratio and Liver Metachronous Metastases in Colorectal Cancer

Destri

Privitera

Greca

et al. 2016

International Surgery

View full text Add to dashboard Cite

Abstract:Objective The authors seek to assess whether the LNR could predict the risk of metachronous liver metastases. Background data Using the goal of sampling 12 lymph nodes for a proper staging of colorectal cancer is often "uncommon" and the lymph node ratio (LNR) is what allows for a better prognosis selection of patients. Methods A homogeneous group of 280 patients, followed-up for at least 5 years, was evaluated. In order to highlight the groups with the highest risk of metachronous liver metastases, patients were divided into four quartiles groups in relation to the LNR. Results The number of lymph nodes sampled in group "stage I" was significantly lower. Even if statistical significance between the global LNR and the development of liver metastases has not been reached, the subdivision into quartiles has made it possible to highlight that in the more advanced ratio groups, a higher incidence of metachronous liver metastases (p <0.028) was registered and was a different distribution of patients with or without liver metastasis in function of quartiles (P =0.01).Conclusions The LNR has enabled us to prognosticate patients who are at greater risk of developing metachronous liver metastases. The lower lymph node sampling in the patients with less advanced staging (I) and in patients with node-negative cancer (I+II) who developed liver metastases, leads us to believe that some patients have been understaged. We believe that the LNR, especially in cases of adequate lymph node sampling, is a useful gauge to better sub-stratify "node-positive" patients. Powered by Editorial Manager® and ProduXion Manager® from Aries Systems CorporationCover LetterClick here to access/download Cover Letter cover letter.pdf

show abstract

The impact of audit and feedback on nodal harvest in colorectal cancer

Cited by 24 publications

References 32 publications

Real-world data: towards achieving the achievable in cancer care

Real-world data: towards achieving the achievable in cancer care

Novel Methods of Lymph Node Evaluation for Predicting the Prognosis of Colorectal Cancer Patients with Inadequate Lymph Node Harvest

Lymph Node Ratio and Liver Metachronous Metastases in Colorectal Cancer

Contact Info

Product

Resources

About