title: Standard outcome indicators after colon cancer resection. Creation of a nomogram for autoevaluation.
abstract: BACKGROUND
  Lately there has been an increasing interest in identifying quality standards in different pathologies, among them colon cancer due to its great prevalence. The main goal of this study is to define the quality standards of colon cancer surgery based on a large prospective national study dataset.
  
  
  METHODS
  Data from the prospective national study ANACO were used. This study included a consecutive series of patients operated on for colon cancer in 52 Spanish hospitals (2011-2012). Centers with less than 30 patients were excluded. The present analysis finally included 42 centers (2975 patients). Based on the results obtained in 4main indicators from each hospital (anastomotic leak, lymph-nodes found in the specimen, mortality and length of stay), a nomogram that allows the evaluation of the performance of each center was designed. Standard results for further 5 intraoperative and 5 postoperative quality indicators were also reported.
  
  
  RESULTS
  Median of anastomotic leak and mortality rate was 8.5% (25th-75thpercentiles 6.1%-12.4%) and 2.5% (25th-75thpercentiles 0.6%-4.7%), respectively. Median number of nodes found in the surgical specimen was 15,1 (25th-75thpercentiles 18-14 nodes). Median length of postoperative stay was 7.7 days (25th-75thpercentiles 6.9-9.2 days). Based on these data, a nomogram for hospital audit was created.
  
  
  CONCLUSIONS
  Standard surgical results after colon cancer surgery were defined, creating a tool for auto-evaluation and allowing each center to identify areas for improvement in the surgical treatment of colon cancer.
authors.affiliation: Unidad de Cirugía Digestiva, Hospital Universitario y Politécnico La Fe, Universidad de Valencia, Valencia, España. Electronic address: jsanchomuriel@gmail.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Sancho-Muriel
authors.affiliation: Unidad de Cirugía Digestiva, Hospital Universitario y Politécnico La Fe, Universidad de Valencia, Valencia, España.
authors.forename: Matteo
authors.initials: M
authors.lastname: Frasson
authors.affiliation: Unidad de Bioestadística, Instituto de Investigación Sanitaria La Fe, Valencia, España.
authors.forename: David
authors.initials: D
authors.lastname: Hervás
authors.affiliation: Unidad de Cirugía Digestiva, Hospital Universitario y Politécnico La Fe, Universidad de Valencia, Valencia, España.
authors.forename: Blas
authors.initials: B
authors.lastname: Flor-Lorente
authors.affiliation: Servicio de Cirugía General, Hospital Universitario de Getafe, Madrid, España.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Ramos Rodriguez
authors.affiliation: Hospital General Universitario de Alicante, Alicante, España.
authors.forename: Manuel
authors.initials: M
authors.lastname: Romero Simó
authors.affiliation: Hospital Universitari Arnau de Vilanova, Lleida, España.
authors.forename: Jordi
authors.initials: J
authors.lastname: Escoll Rufino
authors.affiliation: Hospital de Cruces, Bilbao, España.
authors.forename: Marta
authors.initials: M
authors.lastname: Santamaría Olabarrieta
authors.affiliation: Hospital Arquitecto Marcide, Ferrol, España.
authors.forename: José
authors.initials: J
authors.lastname: Viñas Martinez
authors.affiliation: Hospital Arnau de Vilanova, Valencia, España.
authors.forename: Manolo
authors.initials: M
authors.lastname: López Bañeres
authors.affiliation: Unidad de Cirugía Digestiva, Hospital Universitario y Politécnico La Fe, Universidad de Valencia, Valencia, España.
authors.forename: Eduardo
authors.initials: E
authors.lastname: García-Granero
mesh_terms: D003082:Colectomy; D003110:Colonic Neoplasms / Q000601:surgery*; D006801:Humans; D049451:Nomograms; D017063:Outcome Assessment, Health Care / Q000592:standards*
keywords: Cirugía de colon; Colon surgery; Colonic neoplasms; Estándares de referencia; Evaluación de resultados; Indicadores de calidad; Neoplasias de colon; Outcome assessment; Quality indicators; Reference standards