Aim:
There have been initiatives to create a European audit project. This paper addresses the issue of differences in data collected by different registries.
Method:
Patients with rectal cancer treated in 2008 and recorded in quality registries from Belgium, Germany/Poland, Spain and Sweden were analysed. The comparison included number of patients, gender, age, ASA-classification, preoperative diagnostic and staging procedures, neoadjuvant therapy, surgical treatment and quality of surgery, postoperative complications, and adjuvant treatment.
Results:
The Belgian database consisted of 622 patients, Germany/Poland 3,393, Spain 1,641 and Sweden 1,826. The percentage of patients in ASA-stages was highly variable.MRI-use was the highest in Spain and Sweden and very low in Germany/Poland. The percentage of cT4 stage tumours in Sweden was much higher than in all other countries. Sweden recorded the highest percentage of primary metastatic disease (20.3%), Belgium the lowest (10.2%). Neoadjuvant therapy in different protocols was administered to 41.2% patients in Germany/Poland, 50.8% in Spain, 55.2% in Belgium and 62% in Sweden.Laparoscopic surgery (conversion rate) was performed for cure in 5% (28%) of patients in Sweden, in 20.8% (20.6%) in Spain, in 28.6% (15.2%) in Belgium and in 14.5% (8.9%) in Germany/Poland.30 day mortality for anterior resection, abdominoperineal resection and Hartmann's procedure in Sweden, Belgium and Spain 2.0%, 2.3% and 3.1%, respectively. The German-Polish database reported an in-hospital mortality of 3.2%.
Conclusion:
A European quality assurance project in rectal cancer is possible only after data collection is standardised.