Post on 27-Dec-2015
Northern Region Colorectal Cancer Audit
(NORCCAG)Colorectal NSSG – Audit meeting
1st April 2006 – 31st July 2010
Dorothy Simms – Audit Co-ordinatorFriday 6th May, 2010
• 3.1 million
• approx 1700 cases/annum
• Prospective Audit
• 1997 – Ongoing
• ‘Population’ based
Process• Extracted from NBOCAP (8012 records)
• Removed duplicate treatments (7020 records)
• Supplemented by Research Fellows and clinicians
• Validation
• Analysis
Appendix 0.30%
Caecum 14.40%
Ascending 9.10%
Hepatic 3.16%
Transverse 5.43%
Splenic 2.48%
Descending 3.29%
Sigmoid 22.76%
Rectosigmoid 8.42%
Rectum 30.66%
Appendix 21Caecum 1011Ascending 639Hepatic 222Transverse 381Splenic 174Descending 231Sigmoid 1598Rectosigmoid 591Rectum 2152
Site of Tumour n=7020
Demographics n=7020
0
200
400
600
800
1000
1200
15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94 95-99 >100
Age Group
Fre
qu
en
cy
Age: Median = 71 (17 -102) Sex: Male 3991 (56.85%) Female 3029 (43.15%)
Denominator n=7020
No Procedure n=1571 (22.4%)**no evidence of surgical procedures although a small number had a pathology recorded
Procedures n=5449**5130 (73.0% of 7020) had a resective procedure
4655 (85.4%) are known to have a resection
160 (2.9%) underwent local excisions
131 (2.4%) patients only had stomas formed
161(3.0%) had their tumours stented
315 (5.8%) recorded as having other procedures
Operative Procedures (n=5449)
Resections Local ExcisionsRight Hemi 1302 (23.9%) TEMS 31 (0.6%)Ext Rt Hemi 382 (7.0%) Per Anal Excision 14 (0.3%)Transverse Col 18 (0.3%) Polypectomy 115 (2.1%)Left Hemi 470 (8.6%)Sigmoid Col 283 (5.2%) Other proceduresAnt Res 1444 (26.5%) Palliative 319 (5.9%)Total Col 100 (1.9%) Other 315 (5.8%)Hartmanns 220 (4.0%)APER 353 (6.5%)Panproctocolectomy 83 (1.5%)
Rectal cancers n=2152
No procedure recorded: n=584 (27.1%) => Denominator = 1568
Resections: n=1252 (79.8%)
APER 342 (21.8%) Lt Hemicolectomy 4 (0.3%)
Ant Res 784 (50.0%) Sigmoid colectomy 4 (0.3%)
Hartmanns 95 (6.1%) Total colectomy 8 (0.6%)
Panproctocolectomy 15 (1.0%)
Local Excisions: n=84 (5.4%)
TEMS 30 (2.0%)
Per anal excision 13 (0.8%)
Polypectomy 41 (2.6%)
Other Procedures: n=232 (14.8%)
83 stomas, 25 stents, 2 Dx Invxs, 1 EUA, 7 open and close, 114 other
Grade of Operating Surgeon by Cancer Unit
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 2 5 7 9 10 11 12 13
Cancer Unit
Per
cen
tag
e
NR
NCCG
SHO
SPR
Registrar
Consultant
ASA classification by Cancer Unit
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 2 5 7 9 10 11 12 13
Cancer Unit
Per
cen
tag
e
V
IV
III
II
I
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 2 5 7 9 10 11 12 13
Cancer Unit
Perc
en
tag
e
LapConverted
LapComplete
Open
Surgical Access – 1st April 2006 to 31st July 2007
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 2 5 7 9 10 11 12 13
Cancer Unit
Perc
en
tag
e
LapConverted
LapComplete
Open
Surgical Access – 1st August 2007 to 31st July 2008
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 2 5 7 9 10 11 12 13
Cancer Unit
Perc
en
tag
e
LapConverted
LapComplete
Open
Surgical Access – 1st August 2008 to 31st July 2009
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 2 5 7 9 10 11 12 13
Cancer Unit
Perc
en
tag
e
LapConverted
LapComplete
Open
Surgical Access – 1st August 2009 to 31st July 2010
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 2 5 7 9 10 11 12 13
Cancer Unit
Per
cen
tag
e
Scheduled
Emergency/Urgent
Elective
Urgency of Operation by Cancer Unit
Dukes Stage by Cancer Unit
1153 patients were recorded as having stage ‘D’ disease
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 2 5 7 9 10 11 12 13
Cancer Unit
Per
cen
tag
e
C
B
A
Stage ‘D’ disease by Cancer Unit
0%
5%
10%
15%
20%
25%
1 2 5 7 9 10 11 12 13
Cancer Unit
Per
cen
tag
e
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1 2 5 7 9 10 11 12 13
Cancer Unit
Perc
en
tag
e 1
2 o
r m
ore
no
des
2006/7
2007/8
2008/9
2009/10
Lymph Node Yield
Role of NORCCAG
Publication and dissemination of results
Regional presentations 6th May 2011
Written Report 27th May 2011
Local presentations June – October 2011
Corrected/validated data regional presentation TSSG
The future of NORCCAG
To be discussed………..