Observatory of the Quality of Surgical Procedures for Digestive Cancers

Moroccan Society of Surgery1,043 enrolled

Overview

Surgery for digestive cancers is managed according to quality standards, validated by the scientific community. Despite the diffusion of these standards through the benchmarks of good practice, the results of the surgery remain disparate. In many countries, this "inequality of opportunity" has justified the establishment of quality assurance systems to measure the results of surgery for one or more localizations of digestive cancer. These surgical audit experiments have shown a positive, rapid and cost-effective impact on complication rates, recurrence rates and overall survival even in the absence of interventional measures. The data collected also helped to improve the management of subgroups of patients usually excluded from clinical trials. In Morocco, the National Cancer Prevention and Control Plan provides for the establishment of a quality assurance system with the introduction of a system for monitoring and evaluating the care of patients. This pilot project is part of this framework, for the group of patients who are candidates for surgery for digestive cancers.

Study Type

OBSERVATIONAL

Enrollment

1,043

Conditions

Digestive System Neoplasms Surgery Surgery--Complications Quality of Health Care Medical Audit

Eligibility

Sex: ALLMin age: 16 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients operated for a digestive cancer, proven or suspected, in a curative or palliative intent In elective situation: inclusion from surgery programming In emergent situation: inclusion no later than 72 hours after surgery * Cancer proven or suspected in the following digestive tract: colon, appendix, anus, rectum, esophagus, stomach, eso-gastric junction, bile ducts, ampulla of Vater , pancreas, duodenum, small intestine and liver. * Patient willing and able to agree to participate in the study Exclusion Criteria: * Patient whose surgical intervention is indicated for: * a condition that is not a digestive tract cancer, including whether retrospectively surgical exploration and / or histological examination reveals digestive localization cancer * proven or suspected cancer of non-digestive location * a proven or suspected cancer of peritoneal localization * Patient whose surgical intervention is indicated for a progressive disease or a local recurrence proven or suspected of a digestive localization cancer having already been the resected (with the exception of situations of iterative liver resection for liver metastasis hepatic and recovery of the tumor bed after the discovery of vesicular cancer on cholecystectomy specimen) * Patients whose intervention is for diagnostic purposes without any curative or palliative intention * Patients whose surgery is a liver transplant * Patients whose surgical intervention is local destruction (radiofrequency, microwaves) exclusively by percutaneous approach (without laparotomy or laparoscopy)

Locations (4)

National Institut of Oncology, Surgical oncology department

Rabat, Please Enter the State Or Province, Morocco

Regional center of oncology, surgical department

Oujda, Morocco

Ibn Sina Hospital, Surgical department A

Rabat, Morocco

Ibn Sina Hospital, Surgical department C

Rabat, Morocco

Outcomes

Primary Outcomes

90-day Mortality rate

Death within 90 days of surgical procedure

Time frame: 90 days from surgery

90-day Complication rate

Defined with by Clavien-Dindo grade I to IV within90 days of surgical procedure

Time frame: 90 days from surgery

3-year Overall survival

Overall survival is defined as time from initiation to death of any cause within 3years of surgical procedure

Time frame: from the date of operation to date of death from any cause, whichever came first, assessed up to 3 year

3-year disease free survival

Disease free survival is defined as time from initiation to death of any cause within 3years of surgical procedure

Time frame: from operation until recurrence of tumor or death from any cause, whichever came first, assessed up to 3 years

Secondary Outcomes

Treatment decisions made within multidisciplinary team meeting / tumour board

For every localization

Time frame: Prior to surgery

Availability/performance of CT chest, abdomen and pelvis scan performed for pre-operative staging

For every localization

Time frame: Prior to surgery