Resection Rates for Stage II or III Rectal Cancer, Stage III Colon Cancer and Stage II or IIIA Non-Small Cell Lung Cancer Patients

Resection Rate for Patients with Stage II or III Rectal Cancer

Definition: The percentage of patients diagnosed with stage II or III rectal cancer who had a surgical resection

Numerator: The number of cases receiving a rectal resection within 1 year of diagnosis

Denominator: The number of stage II and III rectal cancer cases

Data source: Provincial cancer agencies

Measurement timeframe: 2009, 2010, 2011 and 2012 diagnosis years

Stratification variables: Province, sex, age

Provinces submitting data: AB, SK, MB, ON, NB, NS, PE, NL

Province specific notes:

• AB: For 2009, resections were not necessarily limited to the specified types (complete rectum). For 2010/2011/2012, treatment information is based on initially planned treatment to primary site (ACR data). The CCI codes are not identified in the ACR, as such all coded surgeries were included for complete rectum resection. If more than one surgical procedure is performed, the ACR codes the most definitive procedures is documented. The definition of definitive is the surgical procedure with the intent to cure. There are some procedures could not identify the margins are negative.
• MB: For 2010/2011/2012, data were not limited to complete resections where margins are negative.
• NB: For 2010, the surgery information was captured in Cancer Registry instead of Discharge Abstract Database.
• NS: For 2009, cases from Cumberland Health Authority were included. For 2010, collaborative stage variables were used to identify those having resections. Individual charts were reviewed to obtain resection date. Extension codes were used to identify true resections (i.e. polypectomies were not considered resections. For 2010/2011/2012, data were not limited to complete resections where margin is negative.
• PE: For 2010/2011, data were not limited to complete resection where margins are negative.
• NL: For 2010, margin status was not recorded. Ineligible surgeries were excluded. For 2011/2012, data were limited to complete resections where margin is negative.

Notes:

1. Rectal cases defined as ICDO3 codes: C19.9 or C20.9, AJCC group stage at diagnosis = II or III.
2. Excluded lymphoma codes M-95 to M-98. For 2010/2011/2012, data also excluded sarcoma codes (see Appendix 1), neuroendocrine carcinoma, squamous cell carcinoma.
3. Cases for patients under 18 years of age were excluded.
4. Rectal resection identified using CCI codes 1NQ87 or 1NQ89 or see list of descriptors in Appendix 1. For 2009/2010, CCI codes also included INQ59.
5. Resected cases included regardless of margin status.
6. Included cases which last resection data (if multiple)-diagnosis date<=365 days for 2009. For year 2010, 2011 and 2012, the inclusion definition has been updated to include 1st resection date (if multiple)-diagnosis date<=365.

Resection Rate for Patients with Stage III Colon Cancer

Definition: The percentage of patients diagnosed with stage III colon cancer who had a surgical resection

Numerator: The number of cases receiving a colon resection within 1 year of diagnosis

Denominator: The number of stage III colon cancer cases

Data source: Provincial cancer agencies

Measurement timeframe: 2009, 2010, 2011 and 2012 diagnosis year

Stratification variables: Province, sex, age

Provinces submitting data: AB, SK, MB, NB, PE, NL

Province specific notes:

• AB: For 2009, data did not limited to complete resections (colectomy). For 2010/2011/2012, treatment information is based on initially planned treatment to primary site (ACR data). The CCI codes are not identified in the ACR, as such all coded surgeries were included for complete rectum resection. If more than one surgical procedure is performed, the ACR codes the most definitive procedures is documented. The definition of definitive is the surgical procedure with the intent to cure. There are some procedures could not identify the margins are negative. For 2011/2012, through quality assurance, there are a number of cases coded as surgery on the ACR had CCI codes or Billing codes other than the ones listed. The majority of these cases appear to be cases in which the DAD had resection of the rectum even though the patient only had C18.7 sigmoid colon. There are also some cases in which the ACR codes surgery for colon but no records were found in the Inpatient database or Billing data. This may be out of province resection.
• SK: For 2012, data were not limited to complete resections where margins are negative.
• MB: For 2010/2011/2012, data were not limited to complete resections where margins are negative.
• NB: For 2010, the surgery information was captured in Cancer Registry instead of Discharge Abstract Database. For 2012, all surgeries were included where margins are positive or negative.
• PE: For 2010/2011, data were not limited to complete resection where margins are negative.
• NL: For 2010, margin status was not recorded. Ineligible surgeries were excluded. For 2011/2012, data were limited to complete resections where margin is negative.

Notes:

1. Colon cases defined as ICDO3 codes: C18.0-C18.9 for 2009, C18.0 and C18.2 to C18.9 for 2010/ 2011/2012, AJCC group stage at diagnosis = III.
2. Excluded lymphoma codes M-95 to M-98. For 2010/2011/2012, data also excluded sarcoma codes (see Appendix 1), neuroendocrine carcinoma, squamous cell carcinoma.
3. Cases for patients under 18 years of age were excluded.
4. Colon resection identified using CCI codes 1NM87 or 1NM89 or 1NM91 or list of descriptors in Appendix 1.
5. Resected cases included regardless of margin status.
6. Included cases which last resection data (if multiple)-diagnosis date<=365 days for 2009. For year 2010, 2011 and 2012, the inclusion definition has been updated to include 1st resection date (if multiple)-diagnosis date<=365.

Resection Rate for Patients with Stage II or IIIA Non-Small Cell Lung Cancer

Definition: The percentage of patients diagnosed with stage II or IIIA non-small cell lung cancer who had a surgical resection

Numerator: The number of cases receiving a surgical resection within 1 year of diagnosis

Denominator: The number of stage II or IIIA non-small cell lung cancer cases

Data source: Provincial cancer agencies

Measurement timeframe: 2009, 2010, 2011 and 2012 diagnosis year

Stratification variables: Province, sex, age

Provinces submitting data: AB, SK, MB, ON, NB, NS, PE

Province specific notes:

• AB: For 2009, resections not necessarily limited to the specified types (lobectomy, pneumonectomy or segmentectomy). For 2010/2011/2012, treatment information is based on initially planned treatment to the primary site (ACR data). The CCI codes are not identified in the ACR, as such all coded surgeries were included for complete lung resection. If more than one surgical procedure is performed, the most definitive procedure is documented. The definition of definitive is the surgical procedure with the intent to care. This indicator excludes case with stage=”III”.
• SK, MB: For 2012, all surgeries are included where margins are unable to identify as negative.
• NS: For 2010/2011, collaborative stage variables were used to identify those having resections. Individual chart were reviewed to obtain resection date.

Notes:

1. Non-small cell lung cases defined as ICDO3 codes: C34.0 to C34.9, AJCC group stage at diagnosis = II or IIIA.
2. Excluded lymphoma codes M-95 to M-98. For 2010/2011/2012, data also excluded sarcoma codes (see Appendix 1), neuroendocrine carcinoma. For 2010/2011, squamous cell carcinomas was also excluded, but included in 2012.
3. Excluded histology codes: 8002, 8041, 8043, 8044, 8045, 8073 and 8803 in 2010/2011/2012 data.
4. Cases for patients under 18 years of age were excluded.
5. Lung resections defined as CCI codes 1GR87, 1GR89, 1GR91, 1GT59, 1GT87, 1GT89 or 1GT91 or list of descriptors in Appendix 1.
6. Resected cases included regardless of margin status (due to data limitations).
7. Included cases which last resection data (if multiple)-diagnosis date<=365 days.