• 2,300 women
    women were determined to be at high risk for breast cancer by the High Risk Screening Program in Ontario in 2015
  • 86%
    of cancer patients saw a registered dietitian at a regional cancer centre within 14 days of referral in 2016
  • 71%
    of stage III colon cancer patients received chemotherapy within 60 days of after surgery in 2014
  • 86%
    of all cancer surgery patients received their consult within the recommended wait time in 2016, and 87% received their surgery within the recommend wait time
  • Over 43,000
    patients were discussed at comprehensive multidisciplinary cancer conferences (MCCs) in fiscal year 2016/2017
  • About 13%
    of patients who undergo lung, prostate and colorectal surgery have an unplanned hospital visit following surgery
  • 79%
    of breast cancer patients had a guideline-recommended mammogram in the first follow-up year
  • 74%
    of colorectal cancer patients diagnosed in 2013 had a surveillance colonoscopy within 18 months of surgery
  • Over 100
    patient and family advisors, who vary by their type of cancer and experiences, represent diverse regions and work with Cancer Care Ontario to ensure a person-centred cancer system
  • 383,023
    unique patients were screened for symptom severity using Your Symptoms Matter – General Symptoms (YSM-General) in 2016
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Reoperations After Cancer Surgery

 
Measure Desired DirectionAs of this Report
Percentage of reoperations after cancer surgery for patients diagnosed with lung, colorectal and prostate cancer. Black Arrow DownGrey Arrow Null
See Methodology and Approach to find out how the ratings are calculated.

Key findings

Following cancer surgery, a small proportion of patients may develop a complication that requires an unplanned reoperation within 30 days of their original cancer resection. Approximately 2% of lung cancer patients, 5% of colon cancer patients, 6% of rectal cancer patients and 1% of prostate cancer patients had an unplanned reoperation within 30 days after cancer surgery.

Reoperation after cancer surgery

  • Cancer surgery is commonly used to help treat many types of cancer, including lung, prostate and colorectal cancers.
  • Unplanned reoperations after surgery may be due to a number of factors, such as post-operative complications1.
  • Measuring the rate of unplanned reoperations within 30 days of original cancer resection monitors the quality of cancer surgeries.

Description of Flow Chart: Reoperations after Surgery — Figure 1: Percentage of reoperations after thoracic surgery for patients diagnosed with lung cancer, fiscal year 2014/15 - 2015/16

The figure is a flow chart with 7 labeled boxes linked by lines.

Here the flow chart is presented as lists in which the connections are listed beneath each box label. Each box label includes the relevant number and percentage of cancer patients who had a lung resection.

  1. Patients who had lung surgery for cancer treatment: N=5398
    1. Connects to Pneumonectomy: N=228 (4.2%)
      1. Connects to Reoperations: N=13 (5.7%)
    2. Connects to Lobectomy/Bilobectomy: N=2769 (51.3%)
      1. Connects to Reoperations: N=60 (2.2%)
    3. Connects to Segmentectomy/Wedge resection: N=2401 (44.5%)
      1. Connects to Reoperations: N=46 (1.9%)

Report date: December 2016
Data source: CIHI-DAD
Prepared by: Analytics and Informatics, Cancer Care Ontario

Note: Numbers shown are for Ontario. Groups are mutually exclusive. Dashed-line frame denotes data included in Figure 2. Due to rounding, percentages may not add up to 100%.

click to close graph
Close Graph
 Percentage of reoperations after cancer surgeries for patients diagnosed with colorectal cancer, fiscal year 2014/15- 2015/16

Description of Flow Chart: Reoperations after Surgery — Figure 3: Percentage of reoperations after cancer surgeries for patients diagnosed with colorectal cancer, fiscal year 2014/15 - 2015/16

The figure includes a flow charts with 11 labeled boxes linked by lines.

Here the flow chart is presented as lists in which the connections are listed beneath each box label. Each box label includes the relevant number and percentage of cancer patients who had a colorectal resection.

  1. Patients who had colorectal surgery for cancer treatment: N=13298
    1. Connects to Colon: N=9229 (69.4%)
      1. Connects to Laparoscopic: N=4952 (53.7%)
        1. Connects to Reoperations: N=179 (3.6%)
      2. Connects to Open: N=4277 (46.3%)
        1. Connects to Reoperations: N=233 (5.4%)
    2. Connects to Rectum: N=4069 (30.6%)
      1. Connects to Laparoscopic: N=1433 (35.2%)
        1. Connects to Reoperations: N=68 (4.7%)
      2. Connects to Open: N=2636 (64.8%)
        1. Connects to Reoperations: N=176 (6.7%)

Report date: December 2016
Data source: CIHI-DAD
Prepared by: Analytics and Informatics, Cancer Care Ontario

Note: Numbers shown are for Ontario. Groups are mutually exclusive. Due to rounding, percentages may not add up to 100%.

Percentage of reoperations after cancer surgeries for patients diagnosed with prostate cancer, fiscal year 2014/15- 2015/16prostate cancer, fiscal year 2014/15 to 2015/16, by Local Health Integration Network of surgery

Description of Flow Chart: Reoperations after Surgery — Figure 4: Percentage of reoperations after cancer surgeries for patients diagnosed with prostate cancer, fiscal year 2014/15 - 2015/16

The figure includes a flow charts with 7 labeled boxes linked by lines.

Here the flow chart is presented as lists in which the connections are listed beneath each box label. Each box label includes the relevant number and percentage of cancer patients who had a prostate resection.

  1. Patients who had prostate surgery for cancer treatment: N=4751
    1. Connects to Open: N=3075 (64.7%)
      1. Connects to Reoperations: N=26 (0.8%)
    2. Connects to Laparoscopic: N=210 (4.4%)
      1. Connects to Reoperations: †
    3. Connects to Robotic: N=1466 (30.9%)
      1. Connects to Reoperations: N=11 (0.8%)

Report date: December 2016
Data source: CIHI-DAD
Prepared by: Analytics and Informatics, Cancer Care Ontario

Note: Numbers shown are for Ontario. Groups are mutually exclusive. † Values have been suppressed due to small cell counts. Due to rounding, percentages may not add up to 100%.

What do the results show?

Of patients who underwent lung surgery for a lobectomy or bilobectomy, 2% had an unplanned reoperation after cancer surgery (Figures 1 and 2).

  • Patients described in these figures include those who had lobectomies or bilobectomies.
  • Among the patients who undergo lobectomies or bilobectomies for the 2 year period fiscal year 2014/15 through 2015/16, 2.2% had a reoperation after cancer surgery.
  • Reoperation rates for lobectomy or bilobectomy patients varied between designated thoracic surgery centres, from a range of 0% to 5%, indicating low reoperation rates for this patient population.

About 5% of patients who had colon cancer surgery and 6% of patients who had rectal cancer surgery underwent an unplanned reoperation following cancer surgery (Figures 3-5).

  • Among the patients who had colon cancer surgery for the 2 year period fiscal year 2014/15 through 2015/2016, 5% had a reoperation within 30 days.
  • Similarly, among the patients who had rectal cancer surgery, 6% of patients had an unplanned reoperation after surgery.
  • For both colon and rectal cancer surgery, open procedures are associated with a higher reoperation rate than laparoscopic procedures.
  • There is some variation in the reoperation rates for both colon and rectal cancer surgery among regions.

Only 0.8% of prostate cancer patients had an unplanned reoperation following surgery (Figures 3-5).

  • Among the patients who had a prostatectomy during the 2 year period fiscal year 2014/15 through 2015/2016, 0.8% had an unplanned reoperation following prostate cancer surgery.
  • Unplanned 30 day reoperation rates for prostate cancer patients were low across all regions.

Why is this important to patient care?

  • Reoperation rate is a surrogate measure for assessing complications following cancer surgery. Monitoring reoperation rates is a measure of surgical quality of cancer care.
  • Monitoring reoperation rates also highlights the increased expenses to the healthcare system from these unplanned procedures.

Find out more:

View Notes

  1. Kroon, H. M., Breslau, P. J., & Lardenoye, J. W. H. (2007). Can the incidence of unplanned reoperations be used as an indicator of quality of care in surgery?. American Journal of Medical Quality, 22(3), 198-202.