Early outcomes from the Dutch Upper Gastrointestinal Cancer Audit

Busweiler, Linde A. D.; Wijnhoven, Bas P. L.; Henegouwen, Mark I. van Berge; Henneman, D.; Grieken, Nicole C.T. van; Wouters, Michel W. J. M.; Hillegersberg, Richard van; Sandick, Johanna W. van

doi:10.1002/bjs.10303

Cited by 134 publications

(130 citation statements)

References 14 publications

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“…It could be that surgical quality increased over the years due to centralization of stomach surgery in The Netherlands (started in 2009), but no data are currently available to support this hypothesis. Another factor is the start of the Dutch Upper GI Cancer Audit (DUCA) in 2011, which has contributed to an increase in LNY 22. In the DUCA, LNY (>15 nodes) is seen as an important quality indicator, which may have motivated centers to increase their LNY 22.…”

Section: Discussionmentioning

confidence: 99%

“…Another factor is the start of the Dutch Upper GI Cancer Audit (DUCA) in 2011, which has contributed to an increase in LNY 22. In the DUCA, LNY (>15 nodes) is seen as an important quality indicator, which may have motivated centers to increase their LNY 22. This increase may then be due to an improvement in surgical quality, but could also be attributed to a more thorough inspection of the resection specimen by pathologists.…”

Section: Discussionmentioning

confidence: 99%

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A High Lymph Node Yield is Associated with Prolonged Survival in Elderly Patients Undergoing Curative Gastrectomy for Cancer: A Dutch Population-Based Cohort Study

et al. 2017

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PurposeThe aim of this study was to evaluate the influence of lymph node yield (LNY) on postoperative mortality and overall survival in elderly patients with gastric cancer.MethodsThis population-based study included data from The Netherlands Cancer Registry of patients who underwent curative gastrectomy for adenocarcinoma between 2006 and 2014. Patients were divided into two groups based on age (<75 years, young; ≥75 years, elderly). LNY was analyzed as both a categorical variable (low, <15 nodes; intermediate, 15–25 nodes; high, >25 nodes), and a discrete variable. Multivariable analysis was used to evaluate the influence of LNY on 30- and 90-day mortality, as well as overall survival.ResultsA total of 3764 patients were included in the study; 2387 (63%) were classified as ‘young’, and 1377 (37%) were classified as ‘elderly’. The median LNY was 14 in the young group, compared with 11 in the elderly group (p < 0.001). In the elderly group, 851 (62%) patients had a low LNY, 333 (24%) had an intermediate LNY, and 174 (13%) had a high LNY. Multivariable analysis demonstrated that in the elderly patients, a higher LNY was associated with a prolonged overall survival (low: reference; intermediate: hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.62–0.88, p < 0.001; high: HR 0.59, 95% CI 0.45–0.78, p < 0.001), but not with 30-day (p = 0.940) and 90-day mortality (p = 0.573). For young patients, these results were comparable.ConclusionIn both young and elderly patients, a high LNY is associated with prolonged survival but not with an increase in postoperative mortality. Therefore, an extensive lymphadenectomy is the preferred strategy for all patients during gastrectomy in order to provide an optimal oncological result.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A High Lymph Node Yield is Associated with Prolonged Survival in Elderly Patients Undergoing Curative Gastrectomy for Cancer: A Dutch Population-Based Cohort Study

et al. 2017

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“…To improve quality of surgical cancer care in the Netherlands, nationwide outcome registries have been initiated. In 2011, the Dutch Upper Gastrointestinal Cancer Audit (DUCA) was initiated to register all patients undergoing surgery for oesophageal or gastric cancer. Quality measurement of multidimensional care pathways, however, cannot be captured in a single parameter.…”

Section: Introductionmentioning

confidence: 99%

Using textbook outcome as a measure of quality of care in oesophagogastric cancer surgery

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et al. 2018

British Journal of Surgery

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“…3). Ook in andere audits, zoals die voor maagkanker (DUCA), worden dit soort verbeteringen gezien, met een daling van de mortaliteit van 7,7 naar 4,2 % in diezelfde tijdsperiode [8,25]. Ook de gewenste uitkomsten, zoals radicaliteit van rectumcarcinoomresecties, verbeteren aanzienlijk, waarbij het gemiddelde percentage tumorpositieve circumferentiële resectiemarges daalde van 14,2 naar 5,6 % in vier jaar tijd [26].…”

Section: Uitkomstenunclassified

Kwaliteitsregistraties volgens het principe van ‘clinical auditing’

Wouters

2017

Tijdschr Urol

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Samenvatting Wetenschappelijke verenigingen van medisch specialisten hebben de afgelopen jaren kwaliteitsregistraties geïnitieerd die zijn opgezet volgens het clinical-auditing principe. Het primaire doel van deze landelijke audits is het verbeteren van zorguitkomsten, door behandelaars te voorzien van spiegelinformatie, waarmee zij de kwaliteit van hun zorgproces kunnen monitoren en verbeteren. Directe betrokkenheid van dokters bij de opzet en uitvoering van de audit, tijdige terugkoppeling van kwaliteitsaspecten die door henzelf belangrijk worden gevonden en het proactief volgen van ontwikkelingen in de zorg, zijn essentieel voor het succes van kwaliteitsregistraties. De mogelijkheid voor behandelaars om resultaten te monitoren, richtlijnnavolging en de introductie van de mogelijkheid om nieuwe technieken te evalueren en met kwaliteitsintiatieven hun uitkomsten te verbeteren, heeft tot substantiële vermindering van morbiditeit en mortaliteit geleid op diverse chirurgische terreinen. Registratie aan de bron, structurele financiering en goede afspraken over transparantie, zijn essentieel om clinical auditing te bestendigen als krachtig instrument in het kwaliteitsbeleid van wetenschappelijke verenigingen.

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Early outcomes from the Dutch Upper Gastrointestinal Cancer Audit

Cited by 134 publications

References 14 publications

A High Lymph Node Yield is Associated with Prolonged Survival in Elderly Patients Undergoing Curative Gastrectomy for Cancer: A Dutch Population-Based Cohort Study

A High Lymph Node Yield is Associated with Prolonged Survival in Elderly Patients Undergoing Curative Gastrectomy for Cancer: A Dutch Population-Based Cohort Study

Using textbook outcome as a measure of quality of care in oesophagogastric cancer surgery

Kwaliteitsregistraties volgens het principe van ‘clinical auditing’

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