Nationwide oncological networks for resection of colorectal liver metastases in the Netherlands:Differences and postoperative outcomes

INTRODUCTION: Widespread differences in patient demographics and disease burden between hospitals for resection of colorectal liver metastases (CRLM) have been described. In the Netherlands, networks consisting of at least one tertiary referral centre and several regional hospitals have been established to optimize treatment and outcomes. The aim of this study was to assess variation in case-mix, and outcomes between these networks. METHODS: This was a population-based study including all patients who underwent CRLM resection in the Netherlands between 2014 and 2019. Variation in case-mix and... Mehr ...

Verfasser: Elfrink, Arthur K E
Kok, Niels F M
Swijnenburg, Rutger-Jan
den Dulk, Marcel
van den Boezem, Peter B
Hartgrink, Henk H
Te Riele, Wouter W
Patijn, Gijs A
Leclercq, Wouter K G
Lips, Daan J
Ayez, Ninos
Verhoef, Cornelis
Kuhlmann, Koert F D
Buis, Carlijn I
Bosscha, Koop
Belt, Eric J T
Vermaas, Maarten
van Heek, N Tjarda
Oosterling, Steven J
Torrenga, Hans
Eker, Hasan H
Consten, Esther C J
Marsman, Hendrik A
Kazemier, Geert
Wouters, Michel W J M
Grünhagen, Dirk J
Klaase, Joost M
Dokumenttyp: Artikel
Erscheinungsdatum: 2022
Reihe/Periodikum: Dutch Hepato Biliary Audit Group , Elfrink , A K E , Kok , N F M , Swijnenburg , R-J , den Dulk , M , van den Boezem , P B , Hartgrink , H H , Te Riele , W W , Patijn , G A , Leclercq , W K G , Lips , D J , Ayez , N , Verhoef , C , Kuhlmann , K F D , Buis , C I , Bosscha , K , Belt , E J T , Vermaas , M , van Heek , N T , Oosterling , S J , Torrenga , H , Eker , H H , Consten , E C J , Marsman , H A , Kazemier , G , Wouters , M W J M , Grünhagen , D J & Klaase , J M 2022 , ' Nationwide oncological networks for resection of colorectal liver metastases in the Netherlands : Differences and postoperative outcomes ' , European Journal of Surgical Oncology , vol. 48 , no. 2 , pp. 435-448 . https://doi.org/10.1016/j.ejso.2021.09.004
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29608306
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/7ef447c7-ae3c-4f43-8b76-635d78b2a334

INTRODUCTION: Widespread differences in patient demographics and disease burden between hospitals for resection of colorectal liver metastases (CRLM) have been described. In the Netherlands, networks consisting of at least one tertiary referral centre and several regional hospitals have been established to optimize treatment and outcomes. The aim of this study was to assess variation in case-mix, and outcomes between these networks. METHODS: This was a population-based study including all patients who underwent CRLM resection in the Netherlands between 2014 and 2019. Variation in case-mix and outcomes between seven networks covering the whole country was evaluated. Differences in case-mix, expected 30-day major morbidity (Clavien-Dindo ≥3a) and 30-day mortality between networks were assessed. RESULTS: In total 5383 patients were included. Thirty-day major morbidity was 5.7% and 30-day mortality was 1.5%. Significant differences between networks were observed for Charlson Comorbidity Index, ASA 3+, previous liver resection, liver disease, preoperative MRI, preoperative chemotherapy, ≥3 CRLM, diameter of largest CRLM ≥55 mm, major resection, combined resection and ablation, rectal primary tumour, bilobar and extrahepatic disease. Uncorrected 30-day major morbidity ranged between 3.3% and 13.1% for hospitals, 30-day mortality ranged between 0.0% and 4.5%. Uncorrected 30-day major morbidity ranged between 4.4% and 6.0% for networks, 30-day mortality ranged between 0.0% and 2.5%. No negative outliers were observed after case-mix correction. CONCLUSION: Variation in case-mix and outcomes are considerably smaller on a network level as compared to a hospital level. Therefore, auditing is more meaningful at a network level and collaboration of hospitals within networks should be pursued.