Análisis de la calidad asistencial en el tratamiento quirúrgico del cáncer colorrectal. Estudio de ámbito nacional. Resultados del seguimiento / Analysis of the quality of care in surgical treatment of colorectal cancer: National study. Follow-up results

OBJETIVOS: Tomando como referencia la casuística del «Estudio sobre la calidad asistencial en el cáncer colorrectal», llevado a cabo por la Asociación Española de Cirujanos en el año 2008, se analiza el seguimiento de los pacientes. MÉTODO: Estudio multicéntrico, descriptivo, prospectivo y longitudinal de pacientes intervenidos de forma programada por cáncer colorrectal (CCR). Han participado 35 hospitales, aportando 334 pacientes. Se han recogido datos del seguimiento: supervivencia, recidivas y complicaciones. RESULTADOS: Seguimiento medio 28,61 ± 11,32 meses. Seguimiento por Cirugía General 69,2%, recidiva tumoral fue del 23,6%, el 83,3% sistémica; el 28,2% fue sometido a cirugía de rescate. La supervivencia global fue del 76,6% y la supervivencia libre de enfermedad del 65,6% (26,49 ± 11,90 meses). La mortalidad relativa fue del 12,6%. El porcentaje de eventraciones fue del 5,8% y la obstrucción intestinal del 3,5%. CONCLUSIONES: El nivel de calidad y los resultados del seguimiento de los pacientes intervenidos por CCR en España son similares a los observados en la literatura internacional. Existen áreas de mejora seguimiento, diagnóstico más temprano, aumentar tratamientos adyuvantes y neoadyuvantes y establecer la escisión total del mesorrecto como cirugía estándar en cáncer de recto

OBJECTIVES: Using the cases included in the study on the quality of care in colorectal cancer conducted by the Spanish Association of Surgeons in 2008, we present follow-up data. METHOD: Multicenter, descriptive, longitudinal and prospective study of patients operated on a scheduled basis for colorectal cancer. 35 hospitals have contributed data on 334 patients. Follow-up data included: survival, recurrence and complications. RESULTS: Mean follow-up was 28.61±11.32 months. Follow-up by the surgeon was 69.2%, tumor recurrence was 23.6%, in 83.3% it was systemic; and 28.2% underwent salvage surgery. Overall survival was 76.6%, disease-free survival 65.6% (26.49 ± 11.90 months). Tumor related mortality was 12.6%. Percentage of ventral hernias was 5.8% and intestinal obstruction was 3.5%. CONCLUSIONS: Quality and results of follow-up of patients operated on for CRC in Spain are similar to those reported in the scientific literature. Areas for improvement included: follow-up, earlier diagnosis, increased adjuvant and neoadjuvant treatments and total mesorectal excision as standard surgery for rectal cancer

Analysis of the quality of care in surgical treatment of colorectal cancer: national study. Follow-up results.

OBJECTIVES: Using the cases included in the Study on the quality of care in colorectal cancer conducted by the Spanish Association of Surgeons in 2008, we present follow-up data. METHOD: Multicenter, descriptive, longitudinal and prospective study of patients operated on a scheduled basis of colorectal cancer. 35 hospitals have contributed data on 334 patients. Follow-up data: survival, recurrence and complications. RESULTS: Mean follow-up was 28.61±11.32 months. Follow-up by surgeon: 69.2%, tumor recurrence 23.6%, in 83.3% it was systemic; 28.2% underwent salvage surgery. Overall survival was 76.6%, disease-free survival 65.6% (26.49±11.90 months). Tumor related mortality was 12,6%. Percentage of ventral hernias was 5.8%, intestinal obstruction 3.5%. CONCLUSIONS: Quality and results of follow-up of patients operated on for CRC in Spain are similar to those reported in the Scientific literature. Areas for improvement: follow-up, earlier diagnosis, increase adjuvant and neoadjuvant treatments and total mesorectal excision as standard surgery for rectal cancer.