80 - Communication libre
3 juin 2022, 08:30 - 10:00, Panorama 1
Continuous improvement of patient care in a DKG-certified center for colorectal cancer
I. Obrecht, J. Slieker, A. Keerl, A. Nocito, Presenter: I. Obrecht (Baden)
Certified cancer centers are institutions offering an interdisciplinary cooperation to pursue the best possible cancer treatment, based on defined criteria of quality. In the German-speaking part of Switzerland, certification is issued by the German Cancer Society (DKG). A certified colorectal cancer center requires fulfillment of high standards in the fields of research, screening, diagnostics, surgical-medical therapy, follow-up, and palliative care. All patient data must be recorded and are evaluated on a yearly basis by auditing and through benchmarking, to ensure completion of the demanded requirements and track the progress. Having achieved ten years of certification at our hospital, we aimed to evaluate the ameliorations over time.
At our center, patient data have been prospectively collected from 01/01/2011 onwards, in a web-based database. We analyzed the data collected over ten years, comparing patients included from 2011 to 2015, to patients included from 2016 to 2020. A descriptive analysis is shown; statistical comparison will be added for the congress.
In 2011-2015, 310 patients with colon carcinoma and 168 with rectal carcinoma were treated, compared to 305 colon- and 155 rectal carcinomas in 2016-2020. Comparing the first to the second five years of inclusion, the preoperative discussion at the tumor conference increased from 86% to 95% over time; the postoperative discussion at the tumor conference was steadily high with 97% vs 98%. The radiological description of the tumor margin to the mesorectal fascia increased from 38% to 90%. The amount of surgical revisions remained similar over time (10.6% vs 9.1% colon; 8.8% vs 7.9% rectum), as did postoperative mortality (3% vs 3%). Quality of TME went from 73% to 92%, and R0 resections of the rectum from 86% to 97%. Large progress was observed in documentation of the family history (6% vs 67%) and genetic counseling (0% vs. 28%). Additionally, psycho-oncologic care more than doubled (10% vs 24%).
Looking back on our first 10 years as a certified DKG-colorectal cancer center, we have achieved big steps in both surgical as non-surgical care. This amelioration is perceivable already after a few years of participation. The obligatory documentation and yearly revision of established quality criteria pushes hospitals to achieving a higher level of patient care.