Journal article
First National Effort to Optimize the Performance of Cancer Surgery by the American College of Surgeons Commission on Cancer and Cancer Surgery Standards Program: Early Results After Implementation of the Operative Standards
Annals of surgery, Vol.282(3), pp.371-381
09/2025
DOI: 10.1097/SLA.0000000000006785
PMID: 40495788
Abstract
To evaluate the first 3 years of compliance with the American College of Surgeons Commission on Cancer (CoC) Operative Standards.
CoC implemented evidence-based standards to improve the quality of sentinel lymph node biopsy and axillary lymph node dissection for breast cancer (Operative Standards 5.3 and 5.4), wide local excision for melanoma (5.5), colectomy for colon cancer (5.6), proctectomy for rectal cancer (5.7), and pulmonary resection for lung cancer (5.8) at approximately 1,400 programs treating>74% of US cancer patients. Each Operative Standard defines a technical element of the operation and structured documentation.
Compliance data are from site visits conducted between January 1, 2022, and December 31, 2024 (implementation/site visits began in 2021/2022 for 5.7 and 5.8 and 2023/2024 for 5.3-5.6). Compliance with each Operative Standard was determined by evaluation of 7 operative (5.3-5.6) or pathology (5.7, 5.8) reports. Deficiency in technical performance, documentation, or both was considered noncompliance.
Reviewers conducted 974 site visits of Comprehensive Community (44%), Community (23%), Academic Comprehensive (16%), network (12%), NCI-Designated Comprehensive (4%), and other (1%) cancer programs. Program compliance rates ranged from 53% to 88%. Documentation noncompliance was more common for standards 5.3-5.6 (based on operative reports), and technical noncompliance was more common for 5.7 and 5.8 (based on pathology reports). Compliance significantly (P=0.006) varied by program type for 5.8 (highest: 66% at NCI-designated Comprehensive programs; lowest: 37% at Community Cancer programs).
Early compliance with CoC Operative Standards varied, indicating local and large-scale national quality improvement efforts are needed.
Details
- Title: Subtitle
- First National Effort to Optimize the Performance of Cancer Surgery by the American College of Surgeons Commission on Cancer and Cancer Surgery Standards Program: Early Results After Implementation of the Operative Standards
- Creators
- Matthew H G Katz - The University of Texas MD Anderson Cancer CenterAmanda B Francescatti - American College of SurgeonsTimothy W Mullett - University of KentuckyJames Harris - Renown Regional Medical CenterAaron D Bleznak - University of PennsylvaniaHeidi Nelson - American College of SurgeonsRonald J Weigel - University of IowaErin K Reuter - American College of SurgeonsBell M Pastore - American College of SurgeonsElizabeth C Funk - American College of SurgeonsKelley Chan - Loyola University ChicagoPeter J Carpenter - American College of SurgeonsWilliam R Burns - Johns Hopkins University School of MedicineMediget Teshome - University of California, Los AngelesTimothy J Vreeland - Brooke Army Medical CenterKelly K Hunt - The University of Texas MD Anderson Cancer CenterTina J Hieken - Mayo Clinic
- Resource Type
- Journal article
- Publication Details
- Annals of surgery, Vol.282(3), pp.371-381
- DOI
- 10.1097/SLA.0000000000006785
- PMID
- 40495788
- NLM abbreviation
- Ann Surg
- ISSN
- 1528-1140
- eISSN
- 1528-1140
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Grant note
- National Cancer Institute: R01CA288625
This work is supported in part by a grant from the National Cancer Institute R01CA288625 (co-investigator: Weigel).
- Language
- English
- Electronic publication date
- 06/11/2025
- Date published
- 09/2025
- Academic Unit
- Molecular Physiology and Biophysics; Anatomy and Cell Biology; Surgery; Biochemistry and Molecular Biology
- Record Identifier
- 9984829024802771
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