Quality indicators related to the quality of surgical procedures
| QI 9 - Urological fistula rate within 30-post-operative days after a radical parametrectomy | |
| Type | Outcome indicator |
| Description | Any bladder or ureteral fistula diagnosed after a procedure including radical parametrectomy. The fistula rate should be calculated on the basis of data of the preceding 3 years. Radical parametrectomies include radical hysterectomies, radical trachelectomies, and parametrectomies |
| Specifications |
Numerator: number of patients treated in the preceding 3 years who develop ureteral or bladder fistulas within 30-post-operative days Denominator: all patients with cervical cancer undergoing a procedure including radical parametrectomy in the preceding 3 years |
| Target | ≤3% |
| QI 10 - Proportion of patients after primary surgical treatment who have clear vaginal (invasive disease) and parametrial margins | |
| Type | Outcome indicator |
| Description | Clear surgical margins apply for both the vaginal margins and parametrial margins. Using an adequate clinical staging with modern imaging and careful pre-operative vaginal assessment, as defined in the ESGO-ESTRO-ESP guidelines,5–7 positive surgical margins after a radical hysterectomy or trachelectomy should be avoided |
| Specifications |
Numerator: number of patients after primary surgical treatment who have clear surgical margins for invasive disease in the preceding 3 years Denominator: all patients who have undergone primary surgical treatment in the preceding 3 years |
| Target | ≥97% |
| QI 11 - Proportion of patients with a stage T1b disease T-upstaged after surgery | |
| Type | Outcome indicator |
| Description | T-upstaging refers to detection of any involvement of parametria or vagina found on pathology which was unknown before surgery, or a stage shift from T1b1 to T1b2 or higher, from pre-operative assessment to post-operative pathology. Detection of positive LNs is not included |
| Specifications |
Numerator: number of patients with stage T1b disease T-upstaged after surgery, as defined above Denominator: all patients with a stage T1b who have undergone a surgery |
| Target | <10% |
| QI 12 - Recurrence rate at 2 years in patients with a stage pT1b1 with negative lymph nodes (LNs) after primary surgical treatment | |
| Type | Outcome indicator |
| Description | This quality indicator applies to the common tumor types (squamous cell and usual types of adenocarcinoma) and both local or distant recurrences, irrespective of adjuvant treatment strategy |
| Specifications |
Numerator: lymph nodes-negative pT1b1 patients whose disease recurs within 2 years after primary surgical treatment, irrespective of adjuvant treatment strategy, with a minimum of 2 years' follow-up. Denominator: All lymph nodes-negative pT1b1 patients after primary surgical treatment, irrespective of adjuvant treatment strategy, with a minimum of 2 years' follow-up. |
| Target | <10% |