Reporting of Circumferential Resection Margin in Rectal Cancer Surgery

IMPORTANCE: Circumferential resection margin (CRM) in rectal cancer surgery is a major prognostic indicator associated with local recurrence and overall survival. Facility rates of CRM positivity have recently been established as a new quality measure by the Commission on Cancer (CoC); however, the...

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Veröffentlicht in:Archives of surgery (Chicago. 1960) 2023-11, Vol.158 (11), p.1195-1202
Hauptverfasser: Manisundaram, Naveen, DiBrito, Sandra R, Hu, Chung-Yuan, Kim, Youngwan, Wick, Elizabeth, Palis, Bryan, Peacock, Oliver, Chang, George J
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Sprache:eng
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Zusammenfassung:IMPORTANCE: Circumferential resection margin (CRM) in rectal cancer surgery is a major prognostic indicator associated with local recurrence and overall survival. Facility rates of CRM positivity have recently been established as a new quality measure by the Commission on Cancer (CoC); however, the completeness of CRM status reporting is not well characterized. OBJECTIVE: To describe the changes in CRM reporting and factors associated with low rates of reporting. DESIGN, SETTING, AND PARTICIPANTS: A retrospective cohort study was conducted using data from the National Cancer Database between January 2010 and December 2019. Data were analyzed between October 1, 2021, and February 1, 2022. Data from the National Cancer Database included patients diagnosed with nonmetastatic rectal adenocarcinoma receiving surgical treatment at CoC-accredited facilities throughout the US. EXPOSURES: Patient, tumor, and facility-level factors. Facilities were divided by surgical volume, safety-net status, and CoC facility type. MAIN OUTCOMES AND MEASURES: Circumferential resection margin missingness rates. RESULTS: A total of 110 571 patients (59.3% men) with rectal adenocarcinoma who underwent curative-intent surgery at 1307 CoC-accredited hospitals were included for analysis. Reporting of CRM improved over the study period, with a mean (SE) missing 12.0% (0.32%) decreased from 16.3% (0.36%). Academic facilities had a higher missingness than other facility types (14.3% vs 10.5%-12.7%; P 
ISSN:2168-6254
2168-6262
2168-6262
DOI:10.1001/jamasurg.2023.4221