Margins in Prostate Cancer Surgery Methodology
|Short description of Indicator||Percent of pT2 and pT3 radical (or total) prostatectomy pathology reports where positive margin was reported by pT stage|
|Rationale for measurement||
One of the main goals of radical (or total) prostatectomy is the complete eradication of the cancer-containing organ and negative surgical margins. However, clinical expert feedback has previously indicated there is practice variation in the surgical management of prostate cancer patients, leading to high positive margin rates in Ontario. Positive surgical margins are associated with higher rates of cancer recurrence.
The intent of this indicator is to monitor the quality of prostate surgeries by measuring the positive margin rate following radical (or total) prostatectomy. Margin status is a good indicator of the quality of surgery and pathology because it helps predict how the disease will progress and how likely it is to recur.
|Evidence/references for rationale||Recommendations for improving the quality of prostate cancer surgery and pathological assessment in radical prostatectomy: A guideline released in 2008 and updated in 2017.
|Calculations for the indicator||% Reports with Positive Margins (pT2) = (Number of pT2 radical [or total] prostatectomy reports with involved margins)/(Number of pT2 radical [or total] prostatectomy reports)
% Reports with Positive Margins (pT3) = (Number of pT3 radical [or total] prostatectomy reports with involved margins)/(Number of pT3 radical [or total] prostatectomy reports)
|Standardized Rate Calculation||N/A|
|Data sources||Pathology Data Mart|
|Time Frame||CY 2013-2017|
|Denominator description||Patients with pT2 or pT3 disease that had a radical (or total) prostatectomy|
|Numerator description||Patients with positive margins: number of pT2 or pT3 reports with involved margins|
|Data availability & limitations||Excludes: