The following is a summary of “Use of a national registry to define a composite quality metric for rectal cancer,” published in the MARCH 2023 issue of Surgery by Tonelli, et al.
In oncologic surgery, measuring quality has traditionally involved reporting individual metrics, which may be difficult for patients and referring providers to understand. To address the issue, a composite quality metric (CQM) was defined by researchers for a study for resection in rectal cancer.
The National Cancer Database was queried to identify patients who underwent low anterior resection for clinical stage II-III rectal adenocarcinoma between 2010 and 2017. The CQM was defined as appropriate neoadjuvant therapy, margin-negative resection, appropriate lymph node assessment, postoperative length of stay (LOS)< 75th percentile, and no 30-day readmission or mortality.
A total of 19,721 patients met the inclusion criteria, and 8,083 (41%) achieved the CQM. The most common reasons for failing to achieve the CQM were inadequate node assessment (27%) and prolonged LOS (26%). Cox modeling showed that achieving the CQM was independently associated with improved overall survival (adjusted hazard ratio [aHR] 0.70, 95% CI [0.66, 0.75]).
The CQM for resection in rectal cancer was associated with improved survival and may serve as an effective measure of quality.