Quality of treatment in routine care in a population sample of rectal cancer patients
Variations in compliance with rectal cancer treatment guidelines and the effect of quality indicators on long-term outcomes were investigated with data from the Munich Cancer Registry. Patients diagnosed between 1996 and 1998 with an invasive primary rectal tumor which was resected were included in...
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| Veröffentlicht in: | Acta oncologica 2005-01, Vol.44 (1), p.65-74 |
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| container_title | Acta oncologica |
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| creator | Engel, Jutta Kerr, Jacqueline Eckel, Renate Günther, Bernulf Heiss, Markus Heitland, Wolf Jauch, Karl-Walter Siewert, Jörg Rüdiger Hölzel, Dieter |
| description | Variations in compliance with rectal cancer treatment guidelines and the effect of quality indicators on long-term outcomes were investigated with data from the Munich Cancer Registry. Patients diagnosed between 1996 and 1998 with an invasive primary rectal tumor which was resected were included in these analyses (n=884). Median follow up was 5.7 years. Relative and overall survival was examined. Adjusted survival was predicted by UICC stage, grade, age, local recurrence, and residual tumor status. UICC III patients receiving the recommended adjuvant therapy had a significant survival advantage in the multivariate model; UICC II patients did not. Even if there were no significant survival differences there were significant treatment and outcome (regarding local recurrence) variations between hospitals. The variations between hospitals refer to different quality indicators in the individual hospitals. The outcome (regarding survival) appears good in Munich and is comparable with other population studies. Fewer local recurrences, better reporting of the TME technique, greater use of combined therapy and fewer stomas, however, may improve the quality of care in Munich. Variations in care between hospitals should therefore be monitored and controlled. Detailed and frequent feedback to the clinicians is vital to improve quality of care and is possible with cancer registries. |
| doi_str_mv | 10.1080/02841860510007413 |
| format | Article |
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Patients diagnosed between 1996 and 1998 with an invasive primary rectal tumor which was resected were included in these analyses (n=884). Median follow up was 5.7 years. Relative and overall survival was examined. Adjusted survival was predicted by UICC stage, grade, age, local recurrence, and residual tumor status. UICC III patients receiving the recommended adjuvant therapy had a significant survival advantage in the multivariate model; UICC II patients did not. Even if there were no significant survival differences there were significant treatment and outcome (regarding local recurrence) variations between hospitals. The variations between hospitals refer to different quality indicators in the individual hospitals. The outcome (regarding survival) appears good in Munich and is comparable with other population studies. Fewer local recurrences, better reporting of the TME technique, greater use of combined therapy and fewer stomas, however, may improve the quality of care in Munich. Variations in care between hospitals should therefore be monitored and controlled. Detailed and frequent feedback to the clinicians is vital to improve quality of care and is possible with cancer registries.</description><identifier>ISSN: 0284-186X</identifier><identifier>EISSN: 1651-226X</identifier><identifier>DOI: 10.1080/02841860510007413</identifier><identifier>PMID: 15848908</identifier><language>eng</language><publisher>England: Informa UK Ltd</publisher><subject>Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Cohort Studies ; Colorectal Surgery - methods ; Combined Modality Therapy ; Confidence Intervals ; Female ; Germany ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness - pathology ; Neoplasm Staging ; Odds Ratio ; Probability ; Prognosis ; Proportional Hazards Models ; Quality of Health Care ; Rectal Neoplasms - mortality ; Rectal Neoplasms - pathology ; Rectal Neoplasms - therapy ; Registries ; Risk Assessment ; Sampling Studies ; Survival Analysis ; Treatment Outcome</subject><ispartof>Acta oncologica, 2005-01, Vol.44 (1), p.65-74</ispartof><rights>2005 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c351t-cb7b8d6e07ad92424636c941d1faacc8d09d22823a30b35bb254f72c94cf56ac3</citedby><cites>FETCH-LOGICAL-c351t-cb7b8d6e07ad92424636c941d1faacc8d09d22823a30b35bb254f72c94cf56ac3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.tandfonline.com/doi/pdf/10.1080/02841860510007413$$EPDF$$P50$$Ginformahealthcare$$H</linktopdf><linktohtml>$$Uhttps://www.tandfonline.com/doi/full/10.1080/02841860510007413$$EHTML$$P50$$Ginformahealthcare$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,61198,61379</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15848908$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Engel, Jutta</creatorcontrib><creatorcontrib>Kerr, Jacqueline</creatorcontrib><creatorcontrib>Eckel, Renate</creatorcontrib><creatorcontrib>Günther, Bernulf</creatorcontrib><creatorcontrib>Heiss, Markus</creatorcontrib><creatorcontrib>Heitland, Wolf</creatorcontrib><creatorcontrib>Jauch, Karl-Walter</creatorcontrib><creatorcontrib>Siewert, Jörg Rüdiger</creatorcontrib><creatorcontrib>Hölzel, Dieter</creatorcontrib><title>Quality of treatment in routine care in a population sample of rectal cancer patients</title><title>Acta oncologica</title><addtitle>Acta Oncol</addtitle><description>Variations in compliance with rectal cancer treatment guidelines and the effect of quality indicators on long-term outcomes were investigated with data from the Munich Cancer Registry. Patients diagnosed between 1996 and 1998 with an invasive primary rectal tumor which was resected were included in these analyses (n=884). Median follow up was 5.7 years. Relative and overall survival was examined. Adjusted survival was predicted by UICC stage, grade, age, local recurrence, and residual tumor status. UICC III patients receiving the recommended adjuvant therapy had a significant survival advantage in the multivariate model; UICC II patients did not. Even if there were no significant survival differences there were significant treatment and outcome (regarding local recurrence) variations between hospitals. The variations between hospitals refer to different quality indicators in the individual hospitals. The outcome (regarding survival) appears good in Munich and is comparable with other population studies. Fewer local recurrences, better reporting of the TME technique, greater use of combined therapy and fewer stomas, however, may improve the quality of care in Munich. Variations in care between hospitals should therefore be monitored and controlled. Detailed and frequent feedback to the clinicians is vital to improve quality of care and is possible with cancer registries.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Cohort Studies</subject><subject>Colorectal Surgery - methods</subject><subject>Combined Modality Therapy</subject><subject>Confidence Intervals</subject><subject>Female</subject><subject>Germany</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness - pathology</subject><subject>Neoplasm Staging</subject><subject>Odds Ratio</subject><subject>Probability</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Quality of Health Care</subject><subject>Rectal Neoplasms - mortality</subject><subject>Rectal Neoplasms - pathology</subject><subject>Rectal Neoplasms - therapy</subject><subject>Registries</subject><subject>Risk Assessment</subject><subject>Sampling Studies</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>0284-186X</issn><issn>1651-226X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMo7rr6A7xITt6qSdp8LJ5E_IIFEVzYW5mmKdulTWqSHvbfm7ILHgRPwzDP-8I8CF1TckeJIveEqYIqQTglhMiC5idoTgWnGWNic4rm0z1LwGaGLkLYJYjlkp-jGeWqUEui5mj9OULXxj12DY7eQOyNjbi12LsxttZgDd5MO-DBDWMHsXUWB-iHzkwZb3SELlFWG4-HdE75cInOGuiCuTrOBVq_PH89vWWrj9f3p8dVpnNOY6YrWalaGCKhXrKCFSIXelnQmjYAWquaLGvGFMshJ1XOq4rxopEsIbrhAnS-QLeH3sG779GEWPZt0KbrwBo3hlJIKalQMoH0AGrvQvCmKQff9uD3JSXl5LL84zJlbo7lY9Wb-jdxlJeAhwPQ2sb5HrYGuridhJU7N3qbPv-n_gePE4Hg</recordid><startdate>20050101</startdate><enddate>20050101</enddate><creator>Engel, Jutta</creator><creator>Kerr, Jacqueline</creator><creator>Eckel, Renate</creator><creator>Günther, Bernulf</creator><creator>Heiss, Markus</creator><creator>Heitland, Wolf</creator><creator>Jauch, Karl-Walter</creator><creator>Siewert, Jörg Rüdiger</creator><creator>Hölzel, Dieter</creator><general>Informa UK Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20050101</creationdate><title>Quality of treatment in routine care in a population sample of rectal cancer patients</title><author>Engel, Jutta ; Kerr, Jacqueline ; Eckel, Renate ; Günther, Bernulf ; Heiss, Markus ; Heitland, Wolf ; Jauch, Karl-Walter ; Siewert, Jörg Rüdiger ; Hölzel, Dieter</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-cb7b8d6e07ad92424636c941d1faacc8d09d22823a30b35bb254f72c94cf56ac3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</topic><topic>Cohort Studies</topic><topic>Colorectal Surgery - methods</topic><topic>Combined Modality Therapy</topic><topic>Confidence Intervals</topic><topic>Female</topic><topic>Germany</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness - pathology</topic><topic>Neoplasm Staging</topic><topic>Odds Ratio</topic><topic>Probability</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Quality of Health Care</topic><topic>Rectal Neoplasms - mortality</topic><topic>Rectal Neoplasms - pathology</topic><topic>Rectal Neoplasms - therapy</topic><topic>Registries</topic><topic>Risk Assessment</topic><topic>Sampling Studies</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Engel, Jutta</creatorcontrib><creatorcontrib>Kerr, Jacqueline</creatorcontrib><creatorcontrib>Eckel, Renate</creatorcontrib><creatorcontrib>Günther, Bernulf</creatorcontrib><creatorcontrib>Heiss, Markus</creatorcontrib><creatorcontrib>Heitland, Wolf</creatorcontrib><creatorcontrib>Jauch, Karl-Walter</creatorcontrib><creatorcontrib>Siewert, Jörg Rüdiger</creatorcontrib><creatorcontrib>Hölzel, Dieter</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Acta oncologica</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Engel, Jutta</au><au>Kerr, Jacqueline</au><au>Eckel, Renate</au><au>Günther, Bernulf</au><au>Heiss, Markus</au><au>Heitland, Wolf</au><au>Jauch, Karl-Walter</au><au>Siewert, Jörg Rüdiger</au><au>Hölzel, Dieter</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Quality of treatment in routine care in a population sample of rectal cancer patients</atitle><jtitle>Acta oncologica</jtitle><addtitle>Acta Oncol</addtitle><date>2005-01-01</date><risdate>2005</risdate><volume>44</volume><issue>1</issue><spage>65</spage><epage>74</epage><pages>65-74</pages><issn>0284-186X</issn><eissn>1651-226X</eissn><abstract>Variations in compliance with rectal cancer treatment guidelines and the effect of quality indicators on long-term outcomes were investigated with data from the Munich Cancer Registry. Patients diagnosed between 1996 and 1998 with an invasive primary rectal tumor which was resected were included in these analyses (n=884). Median follow up was 5.7 years. Relative and overall survival was examined. Adjusted survival was predicted by UICC stage, grade, age, local recurrence, and residual tumor status. UICC III patients receiving the recommended adjuvant therapy had a significant survival advantage in the multivariate model; UICC II patients did not. Even if there were no significant survival differences there were significant treatment and outcome (regarding local recurrence) variations between hospitals. The variations between hospitals refer to different quality indicators in the individual hospitals. The outcome (regarding survival) appears good in Munich and is comparable with other population studies. Fewer local recurrences, better reporting of the TME technique, greater use of combined therapy and fewer stomas, however, may improve the quality of care in Munich. 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| subjects | Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols - therapeutic use Cohort Studies Colorectal Surgery - methods Combined Modality Therapy Confidence Intervals Female Germany Humans Male Middle Aged Neoplasm Invasiveness - pathology Neoplasm Staging Odds Ratio Probability Prognosis Proportional Hazards Models Quality of Health Care Rectal Neoplasms - mortality Rectal Neoplasms - pathology Rectal Neoplasms - therapy Registries Risk Assessment Sampling Studies Survival Analysis Treatment Outcome |
| title | Quality of treatment in routine care in a population sample of rectal cancer patients |
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