Key result
Data collection across European rectal cancer registries was highly variable, with 30-day mortality ranging from 2.0% in Sweden to 3.1% in Spain, indicating a need for standardization.
Observational (n=7,482)
Yes
A European quality assurance project in rectal cancer requires standardization of data collection due to significant variability across national registries.
Variable registry data may limit reliable cross-country benchmarking of rectal cancer outcomes; leaves open whether standardization improves care evaluation.
AIM: There have been initiatives to create a European audit project. This paper addresses the issue of differences in data collected by different registries. METHOD: Patients with rectal cancer treated in 2008 and recorded in quality registries from Belgium, Germany/Poland, Spain and Sweden were analyzed. The comparison included number of patients, gender, age, American Society of Anesthesiology (ASA) classification, preoperative diagnostic and staging procedures, neoadjuvant therapy, surgical treatment and quality of surgery, postoperative complications and adjuvant treatment. RESULTS: The Belgian database consisted of 622 patients, the German/Polish database consisted of 3,393 patients, the Spanish database consisted of 1,641 patients and the Swedish database consisted of 1,826 patients. The percentage of patients in each ASA stage was highly variable. MRI use was highest in Spain and Sweden and very low in Germany/Poland. The percentage of cT4 stage tumours in Sweden was much higher than in all other countries. Sweden recorded the highest percentage of primary metastatic disease (20.3%) and Belgium recorded the lowest (10.2%). Neoadjuvant therapy in different protocols was administered to 41.2% patients in Germany/Poland, to 50.8% in Spain, to 55.2% in Belgium and to 62% in Sweden. Laparoscopic surgery (conversion rate) was performed for cure in 5% (28%) of patients in Sweden, in 20.8% (20.6%) in Spain, in 28.6% (15.2%) in Belgium and in 14.5% (8.9%) in Germany/Poland. The 30-day mortality for anterior resection, abdominoperineal excision and Hartmann's procedure in Sweden, Belgium and Spain was 2.0%, 2.3% and 3.1%, respectively. The German/Polish database reported an in-hospital mortality of 3.2%. CONCLUSION: A European quality assurance project in rectal cancer is possible only after data collection is standardized.
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Mroczkowski et al. (2011) conducted an observational in Rectal cancer (n=7,482). Country of treatment / Registry vs. Other countries/registries was evaluated on 30-day mortality / in-hospital mortality. Data collection across European rectal cancer registries was highly variable, with 30-day mortality ranging from 2.0% in Sweden to 3.1% in Spain, indicating a need for standardization.
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