Quality performance indicators for oesophageal and gastric cancer: ANZ expert Delphi consensus.
oesophageal adenocarcinoma
oesophageal cancer
quality improvement
quality indicator
Journal
ANZ journal of surgery
ISSN: 1445-2197
Titre abrégé: ANZ J Surg
Pays: Australia
ID NLM: 101086634
Informations de publication
Date de publication:
28 Jul 2024
28 Jul 2024
Historique:
revised:
29
06
2024
received:
13
02
2024
accepted:
07
07
2024
medline:
29
7
2024
pubmed:
29
7
2024
entrez:
29
7
2024
Statut:
aheadofprint
Résumé
Quality performance indicators for the management of oesophagogastric cancer can be used to objectively measure and compare the performance of individual units and capture key elements of patient care to improve patient outcomes. Two systematic reviews were completed to identify evidence-based quality performance indicators for the surgical management of oesophagogastric cancer. Based on the indicators identified, a two-round modified Delphi process with invitations was sent to all members of the Australia and Aotearoa New Zealand Gastric and Oesophageal Surgery Association. The expert working group discussed each suggested indicator and either removed, added, or adjusted the list of indicators of oesophagogastric cancer. The final list of both OG cancer indicators included Specialized Multi-disciplinary team discussion, Endoscopy documentation, Staging Contrast CT Chest/Abdomen and Pelvis, Neoadjuvant or Adjuvant chemo/radiotherapy administered in accordance with the Local multi-disciplinary team, Pathological margin clearance (R0 Resection), Lymphadenectomy retrieving 15 or more nodes, Formal review of pathological findings and documentation, Postoperative complications, 30-day and 90-day postoperative mortality, clinical surveillance and Specialized Dietetic guidance. Indicators specific to gastric cancer included Preoperative biopsy for pathological diagnosis and Staging Laparoscopy. Indicators specific to oesophageal cancer include positron emission tomography scan if CT negative for metastasis, Perioperative Oesophagectomy Care Pathway, length of stay of 21 days or more, and Unplanned readmission within 30 days. The results of this study present a core set of indicators for the surgical management of oesophagogastric cancer that can be used to measure quality and compare performance between different units.
Sections du résumé
BACKGROUND
BACKGROUND
Quality performance indicators for the management of oesophagogastric cancer can be used to objectively measure and compare the performance of individual units and capture key elements of patient care to improve patient outcomes.
METHODS
METHODS
Two systematic reviews were completed to identify evidence-based quality performance indicators for the surgical management of oesophagogastric cancer. Based on the indicators identified, a two-round modified Delphi process with invitations was sent to all members of the Australia and Aotearoa New Zealand Gastric and Oesophageal Surgery Association. The expert working group discussed each suggested indicator and either removed, added, or adjusted the list of indicators of oesophagogastric cancer.
RESULTS
RESULTS
The final list of both OG cancer indicators included Specialized Multi-disciplinary team discussion, Endoscopy documentation, Staging Contrast CT Chest/Abdomen and Pelvis, Neoadjuvant or Adjuvant chemo/radiotherapy administered in accordance with the Local multi-disciplinary team, Pathological margin clearance (R0 Resection), Lymphadenectomy retrieving 15 or more nodes, Formal review of pathological findings and documentation, Postoperative complications, 30-day and 90-day postoperative mortality, clinical surveillance and Specialized Dietetic guidance. Indicators specific to gastric cancer included Preoperative biopsy for pathological diagnosis and Staging Laparoscopy. Indicators specific to oesophageal cancer include positron emission tomography scan if CT negative for metastasis, Perioperative Oesophagectomy Care Pathway, length of stay of 21 days or more, and Unplanned readmission within 30 days.
CONCLUSIONS
CONCLUSIONS
The results of this study present a core set of indicators for the surgical management of oesophagogastric cancer that can be used to measure quality and compare performance between different units.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 Royal Australasian College of Surgeons.
Références
Staal EC, Wouters MW, Boot H, Tollenaar RA, van Sandick JW. Quality‐of‐care indicators for oesophageal cancer surgery: a review. Eur. J. Surg. Oncol. 2010; 36: 1035–1043.
Burton PR, Ooi GJ, Shaw K, Smith AI, Brown WA, Nottle PD. Assessing quality of care in oesophago‐gastric cancer surgery in Australia. ANZ J. Surg. 2018; 88: 290–295.
Birkmeyer JD, Stukel TA, Siewers AE, Goodney PP, Wennberg DE, Lucas FL. Surgeon volume and operative mortality in the United States. N. Engl. J. Med. 2003; 349: 2117–2127.
Rouvelas I, Lagergren J. The impact of volume on outcomes after oesophageal cancer surgery. ANZ J. Surg. 2010; 80: 634–641.
Kulasegaran S, Wang Y, Woodhouse B, Maccormick A, Srinivasa S, Koea J. Quality performance indicators for the surgical treatment of oesophageal cancer‐ a systematic review. Dis. Esophagus 2023; 36: doad052‐013.
Kulasegaran S, Woodhouse B, MacCormick AD, Srinivasa S, Koea J. Quality performance indicators for the surgical treatment of gastric adenocarcinoma: a systematic review. ANZ J. Surg. 2022; 92: 1995–2002.
Australian and Aotearoa New Zealand Gastric and Oesophageal Surgery Association [Internet]. South Australia (Australia): Australian and Aotearoa New Zealand Gastric and Oesophageal Surgery Association [date unknown]. Available from URL: https://aanzgosa.org.
Rourke AJ. Evaluating the quality of medical care. Hosp. Prog. 1957; 38: 72–73.
SurveyMonkey Inc [Internet]. San Mateo (USA): Survey Monkey [date unknown]. Available from URL: www.surveymonkey.com
R‐core team. A language and environment for statistical computing [Internet]. Vienna (Austria): the R Foundation. [Cited 1 June 2023.] Available from URL: https://www.R-project.org
Fitch K, Bernstein SJ, Aguilar MD, Burnand B, LaCalle JR. The RAND/UCLA Appropriateness Method user's Manual. Santa Monica, CA: RAND Corporation, 2001.
Woodhouse B, Barreto SG, Soreide K et al. A core set of quality performance indicators for HPB procedures: a global consensus for hepatectomy, pancreatectomy, and complex biliary surgery. HPB 2023; 25: 924–932.
Woodhouse B, Panesar D, Koea J. Quality performance indicators for hepato‐pancreatico‐biliary procedures: a systematic review. HPB. 2021; 23: 1.
Kalff MC, Vesseur I, Eshuis WJ et al. The association of textbook outcome and long‐term survival after oesophagectomy for esophageal cancer. Ann. Thorac. Surg. 2021; 112: 1134–1141.
Cunningham D, Allum WH, Stenning SP et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N. Engl. J. Med. 2006; 355: 11–20.
Al‐Batran SE, Homann N, Pauligk C et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro‐oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet 2019; 393: 1948–1957.
Shapiro J, van Lanschot JJ, Hulshof MC et al. Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long‐term results of a randomised controlled trial. Lancet Oncol. 2015; 16: 1090–1098.
Reynolds JV, Preston SR, O'Neill B et al. Trimodality therapy versus perioperative chemotherapy in the management of locally advanced adenocarcinoma of the oesophagus and oesophagogastric junction (neo‐AEGIS): an open‐label, randomised, phase 3 trial. Lancet Gastroenterol. Hepatol. 2023; 8: 1015–1027.
Donlon NE, Moran B, Kamilli A et al. CROSS versus FLOT regimens in esophageal and esophagogastric junction adenocarcinoma: a propensity‐matched comparison. Ann. Surg. 2022; 276: 792–798.
Gordon TA, Bowman HM, Bass EB et al. Complex gastrointestinal surgery: impact of provider experience on clinical and economic outcomes. J. Am. Coll. Surg. 1999; 189: 46–56.
Verhoef C, van de Weyer R, Schaapveld M, Bastiaannet E, Plukker JT. Better survival in patients with esophageal cancer after surgical treatment in university hospitals: a plea for performance by surgical oncologists. Ann. Surg. Oncol. 2007; 14: 1678–1687.
Ashcraft AS. Failure to rescue. Am. J. Nurs. 2003; 103: 1–31.
Busweiler LA, Henneman D, Dikken JL et al. Failure‐to‐rescue in patients undergoing surgery for esophageal or gastric cancer. Eur. J. Surg. Oncol. 2017; 43: 1962–1969.
Stephens MR, Lewis WG, Brewster AE et al. Multidisciplinary team management is associated with improved outcomes after surgery for esophageal cancer. Dis. Esophagus 2006; 19: 164–171.
Huang YC, Kung PT, Ho SY, Tyan YS, Chiu LT, Tsai WC. Effect of multidisciplinary team care on survival of oesophageal cancer patients: a retrospective nationwide cohort study. Sci. Rep. 2021; 11: 13243.
Preston SR, Markar SR, Baker CR, Soon Y, Singh S, Low DE. Impact of a multidisciplinary standardized clinical pathway on perioperative outcomes in patients with oesophageal cancer. J. Br. Surg. 2013; 100: 105–112.