Early outcomes from the Dutch Upper Gastrointestinal Cancer Audit. Issue 13 (5th October 2016)

• Record Type: Journal Article
• Authors: Busweiler, L. A. D.; Wijnhoven, B. P. L.; van Berge Henegouwen, M. I.; Henneman, D.; van Grieken, N. C. T.; Wouters, M. W. J. M.; van Hillegersberg, R.; van Sandick, J. W.
• Other Names: Bosscha K. investigator.; Cats A. investigator.; Dikken J. L. investigator.; Hartgrink H. H. investigator.; de Jong P. C. investigator.; Lemmens V. E. P. P. investigator.; Nieuwenhuijzen G. A. P. investigator.; Plukker J. T. investigator.; Rosman C. investigator.; Rozema T. investigator.; Siersema P. D. investigator.; Tetteroo G. investigator.; Veldhuis P. M. J. F. investigator.; Voncken F. E. M. investigator.
• Is Part Of: British journal of surgery. Volume 103:Issue 13(2016)
• Page Start: 1855
• Page End: 1863
• Publication Date: 2016-10-05
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.10303
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract : Background: In 2011, the Dutch Upper Gastrointestinal Cancer Audit (DUCA) group began nationwide registration of all patients undergoing surgery with the intention of resection for oesophageal or gastric cancer. The aim of this study was to describe the initiation and implementation of this process along with an overview of the results. Methods: The DUCA is part of the Dutch Institute for Clinical Auditing. The audit provides (surgical) teams with reliable, weekly updated, benchmarked information on process and (case mix‐adjusted) outcome measures. To accomplish this, a web‐based registration was designed, based on a set of predefined quality measures. Results: Between 2011 and 2014, a total of 2786 patients with oesophageal cancer and 1887 with gastric cancer were registered. Case ascertainment approached 100 per cent for patients registered in 2013. The percentage of patients with oesophageal cancer starting treatment within 5 weeks of diagnosis increased significantly over time from 32·5 per cent in 2011 to 41·0 per cent in 2014 ( P < 0·001). The percentage of patients with a minimum of 15 examined lymph nodes in the resected specimen also increased significantly for both oesophageal cancer (from 50·3 per cent in 2011 to 73·0 per cent in 2014; P < 0·001) and gastric cancer (from 47·5 per cent in 2011 to 73·6 per cent in 2014; P < 0·001). Postoperative mortality remained stable (around 4·0 per cent) for patients with oesophageal cancer, and decreased for patients with gastric cancer (from 8·0 per cent in 2011 to 4·0 per cent in 2014; P = 0·031). Conclusion: Nationwide implementation of the DUCA has been successful. The results indicate a positive trend for various process and outcome measures. Abstract : High‐quality national audit when properly resourced