- Author
-
R. Detering
- Title
- Rectal cancer
- Subtitle
- Trends and hospital variation
- Supervisors
-
P.J. Tanis
W.A. Bemelman - Co-supervisors
-
M.W.J.M. Wouters
R. Hompes - Award date
- 29 September 2020
- Number of pages
- 344
- ISBN
- 9789493108141
- Document type
- PhD thesis
- Faculty
- Faculty of Medicine (AMC-UvA)
- Abstract
-
Optimising the multimodality treatment and outcomes for rectal cancer care includes the quality assessment on an international, national and hospital level. Clinical auditing is considered to provide these insights using benchmarked feedback information. The Dutch ColoRectal Audit (DCRA) is a multidisciplinary audit containing high quality short-term data of treated colorectal cancer patients, used as important source of information in provided rectal cancer care on a population-based level. This thesis mainly focused on circumferential resection margin (CRM), a pathological outcome and prognostic factor used in surgically resected rectal cancer patients. We have investigated whether trends or hospital variation on rectal cancer care have impacted CRM outcomes and predicts long-term oncological outcomes. Giving continuously feedback information reflecting daily practice on provided rectal cancer care regarding new treatments, quality, hospital variation, and adherence of the guideline including its outcomes, will potentially facilitate improvement cycles in hospitals or leading to structural changes such as guideline revision. Evaluating current management of rectal cancer care, showed that nowadays still substantial hospital variation exists in providing rectal cancer care. The different studies demonstrate the increased use of a patient-tailored or individualised approach in the treatment of rectal cancer. Specialists tend to use other factors than current guideline recommendations, like patient preferences and the growing availability of different treatment options and surgical techniques.
- Persistent Identifier
- https://hdl.handle.net/11245.1/29be02b2-816e-4b4b-a1a7-1e066162bfff
- Downloads
- Supplementary materials
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