Lymph Node Sampling in Colon Cancer Surgery Methodology
|Short description of Indicator||Percentage of colon cancer surgery reports with 12 or more nodes examined|
|Rationale for measurement||
The Ontario Health (Cancer Care Ontario) guidelines, “Optimization of Surgical and Pathological Quality Performance in Radical Surgery for Colon and Rectal Cancer: Margins and Lymph Nodes Guideline Recommendations, recommend that, for colon cancer patients, 12 or more lymph nodes be removed and examined. https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/566
The guideline recognizes that this will not be possible in 100% of patients. Checking lymph nodes for cancer cells allows accurate staging of the cancer. There is consensus that examination of 12 or more nodes is needed to adequately stage colorectal cancer. Determining the right stage is crucial to making sure the patient receives the most appropriate care after the operation (for example, radiation, chemotherapy or neither). Optimal staging of colon cancer is also an important part of establishing the patient’s prognosis (likely outcome) and course of disease. Patients whose lymph nodes are positive for cancer have a worse prognosis and are more likely to have recurrence (return) of the cancer or have the cancer spread to other parts of the body.
|Evidence/references for rationale||
Recommendations for improving the quality of colon cancer surgery including margin and lymph assessment can be found in a guideline released in 2016. https://www.cancercareontario.ca/en/guidelines-advice/types-of-cancer/566
|Calculations for the indicator||% Colon Cancer Surgery Reports with 12 or more lymph nodes examined = (Number of colon cancer surgery reports with 12 or more lymph nodes examined)/(Number of colon surgery reports)|
|Standardized Rate Calculation||N/A|
|Data sources||Pathology Data Mart|
|Time Frame||CY 2013-2017|
Patients that had colon cancer resection and information on of lymph nodes was specified, or no lymph nodes were submitted or found.
Primary tumour site is one of the following:
|Numerator description||Reports where field "Regional Lymph Nodes Examined" is stated with numeric value 12 or greater|
|Data availability & limitations||