Quality of treatment for colon cancer patients diagnosed from 2015 to 2020 at Hospital Universitário Clementino Fraga Filho

Keywords

colon cancer - treatment quality - quality indicator

Colorectal cancer (CRC) is the third most common cancer and the second most lethal worldwide, according to data from the WHO. In Brazil, colon cancer ranks as the fourth most diagnosed malignant tumor, accounting for 6.5% of all registered neoplasms. CRC treatment is complex, involving surgery and adjuvant chemotherapy. The literature defines certain indicators to assess the quality of this treatment and classify hospitals based on their performance. From this perspective, we conducted a retrospective study at the Hospital Universitário Clementino Fraga Filho (HUCFF), analyzing data from the oncology treatment of 146 colon cancer patients (ICD18) treated between 2015 and 2020.

Methods: We conducted a retrospective observational study using data from the HUCFF electronic medical record, the HUCFF Cancer Hospital Registry (RHC), and the Rio de Janeiro Court of Justice. We assessed parameters defined by the National Quality Forum (NQF), including histopathological staging, the number of lymph nodes analyzed, the time span from diagnosis to the start of adjuvant chemotherapy for stage III patients and the proportion of stage III patients who received adjuvant chemotherapy. We also analyzed the interval between surgical treatment and the start of adjuvant chemotherapy for stage III patients.

Objective: To assess the quality of treatment for this cohort according to the parameters defined by the NQF.

Results: Regarding pathological reports, tumor size (pT) was defined in 88% of cases. Approximately 87% of patients had 12 or more lymph nodes evaluated in the surgical specimen. Of the stage III patients, 75% received adjuvant chemotherapy, while the remaining 25% either died shortly after surgery or were over 80 years old. These results would qualify HUCFF as a high-performance hospital according to NQF criteria. However, only 67% of stage III patients received adjuvant chemotherapy within the recommended 120-day period from diagnosis to treatment. Although the NQF does not include the interval between surgical treatment and the start of adjuvant chemotherapy as a parameter, the literature establishes a higher mortality with a longer interval between these dates—ideally 4 to 8 weeks. At HUCFF, this interval exceeds the expected range, at 10.1 weeks. Future discussions may analyze the overall survival of oncology patients at HUCFF, compare it with other hospitals, and possibly create internal quality indicators.

Corresponding author: Maria Clara Carlos Nunes (e-mail: [e-mail]).

 

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No conflict of interest has been declared by the author(s).

Publication History

Article published online:
06 May 2025