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

KCE Reports 81 PROCARE – phase 2 53Finally, for 19 of the 54 patients treated with adjuvant chemo(radio)therapy, informationwas lacking on the chemotherapy regimen (total missings: 473/1071, 44%).This QI is measurable for 12 centres using the prospective database. Ten centres have ascore of 100%. Ten centres have a score above the weighted (94%; 95%CI 86 – 100%)and unweighted mean (94%; 95%CI 86 – 100%). The range of included eligible patients is1 – 7 per centre.Again, since no administrative code is available for R0 resection, this QI is notmeasurable for the administrative cohort. However, when considering all patients thatunderwent surgery (i.e. not exclusively those with an R0 resection), 99% of the(y)pStage II-III patients that were treated with adjuvant chemotherapy received 5-FUbased adjuvant treatment.Table 43. Number of patients with R0 resection treated with adjuvantchemo(radio)therapy containing 5-FU, measured with prospectivePROCARE data.(y)pStageI II III II-IIIPatients with rectal cancer 246 273 296 569Patients with R0 resection and information on adjuvant treatment 112 127 105 232Patients with chemo(radio)therapy and regimen known9 15 20 35(denominator)Patients with 5-FU regimen (numerator) 8 14 19 33 (94%)Rate of acute grade 4 chemotherapy-related complicationsDEFINITIONNumerator: all patients with (y)pStage 0-III RC that underwent surgery and receivedadjuvant chemotherapy (with or without radiotherapy), and with acute grade 4chemotherapy-related complications.Denominator: all patients with (y)pStage 0-III RC that underwent surgery and receivedadjuvant chemotherapy (with or without radiotherapy).Exclusion:• patients with (y)pStage IV• (y)pStage 0-III patients without surgery• (y)pStage 0-III patients that didn’t receive adjuvant chemo(radio)therapyRESULTSNo acute grade 4 chemotherapy-related complications were identified for the (y)pStage0-III patients treated with adjuvant chemo(radio)therapy (Table 44). As for the previousQI on adjuvant treatment, a high number of missings was identified. For 181 patients the(y)pStage was unknown. For 426 of the 841 (y)pStage 0-III patients undergoing surgery,no information was available on adjuvant treatment. Above this, 9 of the 68 patientsreceiving adjuvant chemo(radio)therapy had a complication, but no information wasavailable on the grade of the complication. For 12 other of these 68 patients, nochemotherapy-related information was available at all. Finally, the number of missingdata for complications cannot be calculated, since the default value of the variable is ‘0’(i.e. missing data also receive a value ‘0’). Therefore, the total number of missing data isat least 628/1071 or 59%.Since no patient with a grade 4 complication was identified, a per-centre-analysis isirrelevant.Due to the absence of a specific code for grade 4 chemotherapy-related complications,this QI is not measurable in the administrative cohort.