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Colorectal cancer: Quality of surgical care in Michigan
Arielle Kanters1, Andrew J Mullard2, Jennifer Arambula2
1Department of Surgery, University of Michigan Health System, Ann Arbor, MI, United States.
Objective:
Surgery remains the cornerstone therapy for colorectal cancer (CRC). This study assesses CRC quality measures for surgical cases in Michigan.
Methods:
In this retrospective cohort study, processes of care and outcomes for CRC resection cases were abstracted in 30 hospitals in the Michigan Surgical Quality Collaborative (2014-2015). Measures were case-mix and reliability adjusted, using logistic regression models.
Results:
For 871 cases (640 colon cancer, 231 rectal cancer), adjusted morbidity (27.4%) and mortality rates (1.5%) were low. Adjusted process measures showed gaps in quality of care. Mesorectal excision was documented in 59.4% of rectal cancer (RC) cases, 65% of RC cases had sphincter preserving surgery, 18.7% of cases had < 12 lymph nodes examined, 7.9% had a positive margin, 52.1% of stage II/III RC cases had neoadjuvant therapy, and 36% of ostomy cases had site marking.
Conclusion:
This study finds gaps in quality of care measures for CRC, suggesting opportunity for regional quality improvement.
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