As part of its work with the National Cancer Comprehensive Cancer Network (see www.nccn.org), our physicians and surgeons at Roswell Park have been very active in defining the best available quality measures to assess cancer care nationwide. Doctors at Roswell Park participated and directed panels of the National Quality Forum, and the American Society of Clinical Society and National Comprehensive Cancer Network that developed quality measures for breast and colon-rectal cancer.

For Colorectal Cancer, these measures include:

1. A minimum of 12 lymph nodes should be removed and examined.
2. For clinical or pathologic AJCC T4N0M0 or Stage III, rectal cancer, less than 80 years of age, and undergoes curative rectal surgery, radiation therapy is administered within 6 months of diagnosis.
3. For Stage III colon cancer, less than 80 years of age, adjuvant chemotherapy is administered within 4 months of diagnosis.

The NCCN established a colorectal cancer database with patient data collection beginning September 1, 2005. The tables show the Roswell Park Cancer Institute scores compared to the other participating National Comprehensive Cancer Network institutions, for patients treated between September 1, 2005 to July 30, 2007. Roswell Park scored as well or better than the other major cancer centers.

Of the two discordant RPCI patients: one was not recommended to have chemotherapy secondary to medical co-morbidities; one had a delay in receiving chemotherapy secondary to a post-operative complication.

Of the three discordant RPCI patients: all received radiation, but were delayed secondary to delay in presentation or co-morbidities. Two were removed from denominator as they were actually sigmoid (above peritoneal reflection) and did not require radiation.

The seven discordant Roswell Park, the node harvest rate ranges from 2-11 with the majority of these cases being Low Anterior Resection. The percentage of nodes recovered/examined at outside facilities (58%) is comparable to 2004 SEER data (52%). The Roswell Park Cancer Institute node recovered/examined rate is comparable to other NCCN centers.