Scholarlink

Purpose <p>Surgical benchmarking provides a reproducible framework for evaluating adherence to quality standards in real-world oncologic settings. We report a 14-year structured benchmarking analysis of surgical quality indicators and Kaplan-Meier (KM) survival outcomes following curative-intent colorectal cancer (CRC) resection at a low-volume tertiary referral center in Mexico.</p> Methods <p>Retrospective, single-center, STROBE-compliant cohort study (January 2010–December 2024). Co-primary outcomes: margin-negative (R0) resection rate and adequate lymph node harvest (≥ 12 nodes). Secondary outcomes: postoperative morbidity (Clavien-Dindo), perioperative 30-day mortality, composite textbook outcome, KM overall survival (OS), and KM disease-free survival (DFS). KM survival was estimated using an interval-censoring approximation from cross-sectional status data. Exact 95% Clopper-Pearson confidence intervals (CI) were reported for all proportions.</p> Results <p>Analytic cohort: <i>n</i> = 48 patients (mean age 65.9 ± 11.5 years; 56.2% male; 54.2% rectal primary; 70.8% stage III–IV; confirmed stage IV M1 oligometastatic: 3 patients [6.2%]; emergency operations: 27.1%; ASA ≥ III: 75.0%; neoadjuvant therapy: 27.1%). Median follow-up: 86.1 months (IQR 45.5–112.2; range 17.3–139.2). R0 resection: 79.2% (95%CI 65.0–89.5%). Adequate LN harvest: 64.6% (95%CI 49.5–77.8%). Postoperative morbidity: 25.0% (95%CI 13.6–39.6%). Perioperative 30-day mortality: 12.5% (95%CI 4.7–25.2%), contextualized by 27.1% emergency operations and 75.0% ASA ≥ III. Textbook outcome: 22.7% (95%CI 11.5–37.8%; available-case, <i>n</i> = 44); worst-case sensitivity: 20.8% (95%CI 10.5–35.0%). KM OS: 68.8% at 5 years; 43.0% at 10 years; median OS ≈ 120 months; 13 events/48. KM DFS: 59.4% at 5 years; 42.4% at 10 years; 15 events/48.</p> Conclusion <p>Structured institutional benchmarking including formal KM survival analysis is feasible in LMIC tertiary settings with historical registry data constraints. The 12.5% perioperative mortality is contextualized by 27.1% emergency operations and 75.0% ASA ≥ III — the primary quality improvement target. KM survival outcomes are consistent with an advanced-stage mixed-site referral cohort. Transparent, risk-contextualized benchmarking generates the evidence base most urgently needed in LMIC surgical oncology programs.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Real-World Institutional Benchmarking of Surgical Quality and Observed Long-Term Oncologic Outcomes Following Curative-Intent Colorectal Cancer Resection in a Low-Volume Tertiary Referral Center in Mexico: A 14-Year STROBE-Compliant Cohort Study

  • 期刊论文

  • 发表日期：

    2026年5月14日

查看全文
  • Ricardo A. González-Jaramillo,
  • Sofía Ley Tapia,
  • Miguel Ángel Monrroy Ramírez

摘要

Purpose

Surgical benchmarking provides a reproducible framework for evaluating adherence to quality standards in real-world oncologic settings. We report a 14-year structured benchmarking analysis of surgical quality indicators and Kaplan-Meier (KM) survival outcomes following curative-intent colorectal cancer (CRC) resection at a low-volume tertiary referral center in Mexico.

Methods

Retrospective, single-center, STROBE-compliant cohort study (January 2010–December 2024). Co-primary outcomes: margin-negative (R0) resection rate and adequate lymph node harvest (≥ 12 nodes). Secondary outcomes: postoperative morbidity (Clavien-Dindo), perioperative 30-day mortality, composite textbook outcome, KM overall survival (OS), and KM disease-free survival (DFS). KM survival was estimated using an interval-censoring approximation from cross-sectional status data. Exact 95% Clopper-Pearson confidence intervals (CI) were reported for all proportions.

Results

Analytic cohort: n = 48 patients (mean age 65.9 ± 11.5 years; 56.2% male; 54.2% rectal primary; 70.8% stage III–IV; confirmed stage IV M1 oligometastatic: 3 patients [6.2%]; emergency operations: 27.1%; ASA ≥ III: 75.0%; neoadjuvant therapy: 27.1%). Median follow-up: 86.1 months (IQR 45.5–112.2; range 17.3–139.2). R0 resection: 79.2% (95%CI 65.0–89.5%). Adequate LN harvest: 64.6% (95%CI 49.5–77.8%). Postoperative morbidity: 25.0% (95%CI 13.6–39.6%). Perioperative 30-day mortality: 12.5% (95%CI 4.7–25.2%), contextualized by 27.1% emergency operations and 75.0% ASA ≥ III. Textbook outcome: 22.7% (95%CI 11.5–37.8%; available-case, n = 44); worst-case sensitivity: 20.8% (95%CI 10.5–35.0%). KM OS: 68.8% at 5 years; 43.0% at 10 years; median OS ≈ 120 months; 13 events/48. KM DFS: 59.4% at 5 years; 42.4% at 10 years; 15 events/48.

Conclusion

Structured institutional benchmarking including formal KM survival analysis is feasible in LMIC tertiary settings with historical registry data constraints. The 12.5% perioperative mortality is contextualized by 27.1% emergency operations and 75.0% ASA ≥ III — the primary quality improvement target. KM survival outcomes are consistent with an advanced-stage mixed-site referral cohort. Transparent, risk-contextualized benchmarking generates the evidence base most urgently needed in LMIC surgical oncology programs.