E2 – Post-operative chemotherapy for stage III colon cancer patients

E2 – Post-operative chemotherapy for stage III colon cancer patients 

Key Messages

•    Over the last three years, 75% of patients with stage III colon cancer started chemotherapy within 12 weeks of surgery.   


​Background

Stage III colon cancer is typically first treated by surgical removal of the tumour. Adding chemotherapy after the patient has recovered from the surgery is known to decrease the risk of the cancer returning and improve overall survival. Chemotherapy started more than 12 weeks after surgery is associated with a detrimental effect on survival for patients with stage III colon cancer.  

Clinical practice guidelines, updated in 2012 by an international consensus conference established by the European Society for Medical Oncology (ESMO), recommend that chemotherapy be started as early as 4 weeks following surgery, up to a maximum of 12 weeks post-surgery.1 The target defined by the RCN Gastrointestinal Disease Site Group is that 80% of stage III colon cancer patients should receive adjuvant chemotherapy within 12 weeks. 

What Do the Results Mean?

Overall, across the Rossy Cancer Network hospitals, 75% of patients with stage III colon cancer start chemotherapy within 12 weeks of surgery.  Measuring how the guidelines are followed allows us to identify variations in clinical practice, which could be addressed through quality improvement strategies.

The management of stage III colon cancer patients involves collaboration between many different specialist and/or disciplines within the same hospital. Many factors can influence the timing of adjuvant chemotherapy. 

Efforts

The RCN Gastrointestinal Disease Site Group is analyzing the process-related factors that delay the start of chemotherapy.  

By optimizing the process flow from surgery to start of chemotherapy at all the RCN partner hospitals, targets can be more consistently achieved.

Data Specifications

DEFINITION 

Percentage of stage III colon cancer patients who start chemotherapy within 12 weeks of surgery

DATA SOURCE   

Cancer registry

NUMERATOR    

Number of stage III colon cancer patients who received chemotherapy ≤ 12 weeks after surgery

DENOMINATOR   

Number of stage III colon cancer patients who received chemotherapy after surgery

EXCLUSIONS

Patients who had their surgery or chemotherapy outside of the Rossy Cancer Network
Patients who received chemotherapy before surgery (neoadjuvant chemotherapy)
Patients who received chemotherapy > 180 days (6 months) after surgery

MEASUREMENT TIMEFRAME  

Yearly

NOTES  

Patients included in the analysis had to have both surgery and chemotherapy performed within the Rossy Cancer Network
Patients receiving oral chemotherapy were included in the analysis
Delays were associated with the hospital where the chemotherapy was administered

References

1.    Schmoll HJ, Van Cutsem E, Stein A et al. ESMO Consensus guidelines for management of patients with colon and rectal cancer. A personalized approach to clinical decision making. Annals of Oncology 23: 2479-2516, 2012. 

Disclaimer: The Rossy Cancer Network has attempted to ensure the accuracy of the data that it is reporting for each of its hospitals. Values posted on this web page may change as new information becomes available or corrections are made; this may alter accumulated values.

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