Review of Colorectal Cancer Quality Performance Indicators Consultation

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Closes 29 Jan 2021

Questions

QPI 1. Radiological Diagnosis and Staging

QPI 1

Radiological Diagnosis and Staging

Patients with colorectal cancer should be evaluated with appropriate imaging to detect extent of disease and guide treatment decision making.

 

Specification (i): Patients with colon cancer who undergo CT chest, abdomen and pelvis before definitive treatment. 95%

Specification (ii): Patients with rectal cancer undergoing definitive treatment (chemoradiotherapy or surgical resection) who undergo CT chest, abdomen and pelvis and MRI pelvis before definitive treatment. 95%

QPI 2. Pre-Operative Imaging of the Colon

QPI 2

Pre-Operative Imaging of the Colon

Patients with colorectal cancer undergoing elective surgical resection should have the whole colon visualised pre-operatively. 95%

 

QPI 3. Lymph Node Yield

QPI 3

Lymph Node Yield

For patients undergoing resection for colorectal cancer the number of lymph nodes examined should be maximised. 90%

QPI 4. Surgical Margins

QPI 4

Surgical Margins

Rectal cancers undergoing surgical resection should be adequately excised.

 

Specification (i): Patients with rectal cancer who undergo elective primary surgical resection or immediate / early surgical resection following neo-adjuvant short course radiotherapy in which the circumferential margin is clear of tumour. 95%

Specification (ii): Patients with rectal cancer who undergo elective surgical resection following neo-adjuvant chemotherapy, long course chemoradiotherapy, long course radiotherapy or short course radiotherapy with long course intent (delay to surgery) in which the circumferential margin is clear of tumour. 85%

 

QPI 5. Re-operation Rates

QPI 5

Re-operation Rates

Patients undergoing surgery for colorectal cancer re-operation rate should be minimised. <10%

 
QPI 6. Anastomotic Dehiscence

QPI 6

Anastomotic Dehiscence

Patients who undergo surgical resection for colorectal cancer anastomotic dehiscence should be minimised.

Specification (i): patients with colorectal cancer who undergo a surgical procedure involving anastomosis of the colon having anastomotic leak requiring intervention (endoscopic, radiological or surgical). <5%

Specification (ii): patients with colorectal cancer who undergo a surgical procedure involving anastomosis of the rectum (including: anterior resection with TME) having anastomotic leak requiring intervention (endoscopic, radiological or surgical). <10%

QPI 7. 30 and 90 Day Mortality Following Surgical Resection

QPI 7

30 and 90 Day Mortality Following Surgical Resection

Mortality after surgical resection for colorectal cancer.

 

Elective surgical resection

30 day mortality <3%

90 day mortality <4%

 

Emergency surgical resection

30 day mortality <15%

90 day mortality <20%

QPI 8. Adjuvant Chemotherapy

QPI 8

Adjuvant Chemotherapy

Patients with Stage III colorectal cancer should be considered for adjuvant chemotherapy. 70%

QPI 9. 30 and 90 Day Mortality Following Radical Radiotherapy

QPI 9

30 and 90 Day Mortality Following Radical Radiotherapy

Mortality after radical radiotherapy treatment for colorectal cancer. <1%

QPI 10. 30 Day Mortality following Systemic Anti-Cancer Therapy (SACT)

QPI 10

30 Day Mortality following Systemic Anti-Cancer Therapy (SACT

30 day mortality following Systemic Anti-Cancer Therapy (SACT) treatment for colorectal cancer.

 

Curable (neoadjuvant / adjuvant - <1%

Non-curable - <5%

QPI 11. New QPI - Colorectal Liver Metastases

QPI 11

New QPI - Colorectal Liver Metastases    

Patients with a new diagnosis of colorectal liver metastases should be referred to a Hepatobiliary (HPB) multidisciplinary team (MDT) to discuss their management.

 

Specification (i): patients with a new diagnosis of synchronous colorectal liver metastases who are referred to a HPB MDT. 95%

Specification (ii): patients with a new diagnosis of metachronous colorectal liver metastases who are referred to a HPB MDT. 95%

QPI 12. New QPI - Assessment of Microsatellite Instability (MSI)/Mismatch Repair (MMR) Status

QPI 12

New QPI - Assessment of Microsatellite Instability (MSI)/Mismatch Repair (MMR) Status

Patients with a new diagnosis of metachronous colorectal liver metastases who are referred to a HPB MDT.

 

Specification (i): Patients less than 60 years of age at diagnosis with colorectal cancer who have their tumour DNA MMR status assessed. 95%

 

Specification (ii): Patients with colorectal cancer less than 60 years of age at diagnosis who have DNA MMR status assessed with results suggestive of Lynch Syndrome and are referred to genetic. 90%

13. Any other comments: