Table 6

Recording pertinent information

QI 25 - Minimum required elements in surgical reports
TypeProcess indicator
DescriptionAccording to the ESGO/ESTRO/ESP guidelines, the surgical report requires inclusion of at least the following elements:
  • Abdominal findings status at start and at end of surgery

  • Description of tumor spread (if any)

  • Lymph node evaluation

  • Complications

  • Total blood loss

  • Tracer used for the sentinel lymph node procedure

  • Number of sentinel lymph nodes removed (if any)

  • Location of sentinel lymph nodes (if any)

  • Residual post-operative disease; location of residual disease (if any)

  • Kind of procedure (sentinel lymph node procedure, debulking, etc)

  • Adhesiolysis (yes vs no)

  • Aim of surgery (palliative vs curative)

  • Stage of the disease

  • Rupture of uterus

SpecificationsNumerator: number of patients who have a complete surgical report that contains all required elements as defined above
Denominator: all patients with endometrial carcinoma who underwent surgery
Target≥99%
QI 26 - Minimum required elements in pathology reports
TypeProcess indicator
DescriptionAccording to the ESGO/ESTRO/ESP guidelines, the minimum required elements in pathology reports include at least the following elements:
  • Description of the specimen(s) submitted for histologic evaluation

  • Attached anatomic structures

  • Accompanying specimens

  • Tumor type (WHO Classification of Tumors (fifth edition))

  • Tumor grade (FIGO and WHO Classification of Tumors (fifth edition))

  • Absence or presence and depth of myometrial invasion

  • Lymphovascular space involvement should be unequivocal and reported as focal and extensive/substantial (five vessels or more)

  • Presence of cervical stromal invasion should be described

  • Presence or absence of vaginal involvement

  • Presence or absence of uterine serosal involvement

  • Presence or absence of parametrial involvement

  • Presence or absence of adnexal involvement

  • Presence or absence of omental involvement

  • Presence or absence of peritoneal involvement

  • Lymph node status, including sentinel lymph node status, reports the total number of nodes found and the number of positive lymph nodes, and the presence of extranodal extension (list for all separates sites). Micrometastasis (>0.2 mm and up to 2 mm) are reported as pN1(mi). Isolated tumor cells no greater than 0.2 mm in regional nodes should be reported as pN0 (i+)

  • Presence or absence of pathologically proven distant metastases

  • Required ancillary techniques

  • Tumor site

  • Tumor size

  • Percentages of different components of mixed carcinoma and in carcinosarcoma

  • Presence or absence of myometrial invasion. Depth of myometrial invasion (none or less than half, or half or more) Measurement should be performed from the adjacent endometrial–myometrial interface

  • Microcystic, elongated, fragmented pattern of invasion

  • Peritoneal cytology (if available).

SpecificationsNumerator: number of patients in whom all minimum required elements as defined above are included in the pathology report
Denominator: all patients with endometrial carcinoma who underwent surgery
Target≥99%
QI 27 - Structured morbidity and mortality conference per year for quality assurance of surgical care
TypeOutcome indicator
DescriptionStructured morbidity and mortality conferences are crucial for quality assurance of surgical care. Complications, reoperations, readmissions, secondary transfers to intermediate or intensive care units, and deaths should be discussed
SpecificationsNumerator: number of structured morbidity and mortality conferences per year
Denominator: not applicable
TargetsOptimal target: 4
Minimum required target: 2
QI 28 - Proportion of reoperations within 30 days for complications after primary minimally invasive surgery
TypeOutcome indicator
DescriptionReoperation due to complications related to surgery
SpecificationsNumerator: number of reoperations for complications after primary minimally invasive surgery
Denominator: all patients with endometrial carcinoma who underwent primary minimally invasive surgery.
Target≤2%
QI 29 - Structured prospective reporting of recurrences/deaths
TypeOutcome indicator
DescriptionThis applies for the first 5 years after diagnosis. Thereafter, patients will be offered to a survivorship program
SpecificationsNumerator: number of audits for recurrences/deaths for all treated patients with endometrial carcinoma per year
Denominator: not applicable.
Target≥once a year