[Quality criteria for treatment of colorectal cancer. From a surgeon's viewpoint].
The surgeon is the key "prognosis factor" for colorectal cancer. For this reason quality criteria were recently established (including minimum numbers) in order to treat patients who are entitled to the best quality of care and to improve the prognosis. The aim of this study was to critically discuss the existing demands on the surgeon based on the current literature and our own results and to formulate evidence-based quality criteria for surgical clinics. After reviewing the current literature criteria were compiled, discussed and finally presented in a summarized form. These are based on current developments on the diagnostic and therapy of large intestine and colorectal carcinoma. New developments of the German Cancer Society for planning of organ centers are incorporated. The quintessence of our study is that the number of cases alone is not decisive for the success of therapy. Important are the application of the correct surgical-oncology operation procedure, adherence to standards and the training of surgeons. Following the S3 guidelines stage-oriented therapy should additionally be carried out in a structured sequence. This includes an interdisciplinary decision making on the diagnostic and therapy strategy (tumor board). The organization structure of the hospital (teams, tumor board, emergency care with intensive care unit, emergency diagnostic and options for interventional measures) can be more important than the hospital case numbers alone. These demands which have been evaluated from published data and own results are designed to raise the therapy of colorectal cancer to the best possible level of quality and to effect a further improvement in the prognosis.
Link
K H
KH
Chirurgisches Zentrum, Asklepios-Paulinen-Klinik, Geisenheimerstrasse 10, 65197 Wiesbaden. k-h.link@asklepios.de
Kornmann
M
M
Bittner
R
R
Köckerling
F
F
Arbogast
R
R
Gastinger
I
I
Heitland
W
W
Henne-Bruns
D
D
Lang
H
H
Lippert
H
H
Mann
M
M
Meyer
H J
HJ
Polonius
M-J
MJ
Post
S
S
Raab
R
R
Schiedeck
T
T
Schumpelick
V
V
D019985:Benchmarking / Q000592:standards; D002983:Clinical Competence / Q000592:standards; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D019091:Critical Pathways / Q000592:standards; D019317:Evidence-Based Medicine / Q000592:standards; D005858:Germany; D019983:Guideline Adherence / Q000592:standards; D006739:Hospital Administration / Q000592:standards; D006801:Humans; D009367:Neoplasm Staging; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards; D011379:Prognosis; D011785:Quality Assurance, Health Care / Q000592:standards*; D012015:Reference Standards; D015996:Survival Rate