Assurance de qualité pour le cancer rectal – phase 2 ...

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24 PROCARE – phase 2 KCE reports 81AllMalesFemalesTable 10. 5-year observed survival rate by (y)pStage using the administrativedatabases*, calculated with actuarial (life table) method.(y)p-stage N N deaths on 31/12/2006 1-year 2-year 3-year 4-year 5-yearI 892 226 93% 89% 84% 79% 74%II 1192 460 90% 83% 74% 66% 60%III 1094 610 85% 70% 57% 48% 42%IV 352 292 70% 46% 27% 17% 14%X 3544 1911 75% 63% 55% 49% 45%I-III 3178 1296 89% 80% 71% 63% 58%Total (I-IV) 7074 3499 81% 70% 61% 54% 49%I 547 147 92% 88% 82% 78% 72%II 704 259 90% 84% 77% 68% 62%III 629 369 83% 68% 54% 45% 40%IV 227 193 69% 46% 26% 14% 11%X 2025 1099 76% 64% 55% 49% 45%I-III 1880 775 89% 80% 71% 63% 57%Total (I-IV) 4132 2067 81% 70% 61% 53% 49%I 345 79 95% 91% 86% 81% 77%II 488 201 89% 81% 72% 64% 56%III 465 241 86% 72% 61% 52% 46%IV 125 99 73% 45% 29% 22% 20%X 1519 812 72% 62% 55% 49% 45%I-III 1298 521 89% 80% 72% 64% 58%Total (I-IV) 2942 1432 80% 69% 61% 55% 49%* Mean follow-up: 38 months (range 0-83 months).Figure 5 provides an overview of the 5-year observed survival of the (y)pStage I-IIIpatients per centre using the administrative database. Fifty-six and 55 centres have a 5-year observed survival above the weighted (58%; 95%CI 56 – 59%) and unweightedmean (58%; 95%CI 55 – 62%) respectively.Figure 5. Per-centre-analysis (n = 112) of the 5-year observed survival of(y)pStage I-III patients (administrative cohort) $ .100200901808016070140Proportion (%)605040301201008060Number of patients (N)2040102000$ The weighted mean is presented with a red bar, the unweighted mean is presented with a bluehorizontal line. The grey bars represent the QI value per centre, while the blue dots representthe number of patients per centre. These results are preliminary, and cannot be used to judge thequality of care.
KCE Reports 81 PROCARE – phase 2 25Disease-specific 5-year survival by stageDEFINITIONNumerator: all RC patients that survived after 5 years or that died due to a diseaseunrelatedcause, by stage.Denominator: all RC patients.Exclusion criteria:• patients treated abroad• patients without a social security number• patients without a Belgian postal code• patients without a known incidence date or with an incidence date afterDecember 31st 2006.RESULTSSince no accurate data are available on the cause of death in both databases, diseasespecificsurvival as such is not measurable at present. Above this, follow-up in thePROCARE database ends in case of local or distant recurrence.However, relative survival is a frequently used parameter in cancer epidemiology andcan be used as a proxy of the disease-specific survival [10]. For the calculation of therelative survival, the numerator is defined as the observed rate of rectal cancer patientssurviving five years after diagnosis, while the denominator is defined as the expectedsurvival rate of a comparable group (age, gender and region) from the generalpopulation.Again, since the PROCARE database is relatively young, a 5-year survival analysis is notyet possible. At present, an accurate survival analysis is only possible at 1 year (Table 11and Table 12) Using the coupled administrative database, a full 5-year survival analysis ispossible (Table 13 and Table 14).For 1062 of the 1071 PROCARE patients (99%) all necessary data were known. Ofthese 1062 patients, 866 had an incidence date before January 1 st 2007.The relative 1-year survival is measurable for 55 centres using the PROCARE databaseand ranges from 66 – 105% for the (y)pStage I-III patients. Thirty-seven centres have a1-year relative survival (for the (y)pStage I-III patients) above the weighted (96%; 95%CI95 – 98%) and unweighted mean (97%; 95%CI 94 – 99%).Table 11. 1-year relative survival rate by cStage using the PROCAREdatabase*, calculated with actuarial (life table) method.N N deaths on 31/12/2006 1-yearAll I 73 0 103%II 124 6 95%III 279 10 97%IV 80 13 76%X 310 21 94%I-III 476 16 97%Total (I-IV) 866 50 94%Males I 42 0 103%II 81 4 95%III 175 8 96%IV 43 4 87%X 181 17 92%I-III 298 12 97%Total (I-IV) 522 33 94%Females I 31 0 102%II 43 2 94%III 104 2 99%IV 37 9 65%X 129 4 97%I-III 178 4 98%Total (I-IV) 344 17 94%* Mean follow-up: 8 months (range 0-24 months).
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35. Etude relative aux coûts poten
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