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van der Heiden-van der Loo M, Siesling S, Wouters MW, et al. Lokale recidieven na operatie voor borstkanker: Verbetering in recente jaren. [The value of ipsilateral breast tumor recurrence as a quality indicator: hospital variation in the Netherlands]. Ned Tijdschr Geneeskd. 2016;160:A9572
van der Heiden-van der Loo, M., Siesling, S., Wouters, M. W., van Dalen, T., Rutgers, E. J., & Peeters, P. H. (2016). Lokale recidieven na operatie voor borstkanker: Verbetering in recente jaren. [The value of ipsilateral breast tumor recurrence as a quality indicator: hospital variation in the Netherlands]. Nederlands tijdschrift voor geneeskunde, 160A9572.
van der Heiden-van der Loo, Margriet, et al. "Lokale recidieven na operatie voor borstkanker: Verbetering in recente jaren." [The value of ipsilateral breast tumor recurrence as a quality indicator: hospital variation in the Netherlands]. Nederlands tijdschrift voor geneeskunde vol. 160 (2016): A9572.
van der Heiden-van der Loo M, Siesling S, Wouters MW, van Dalen T, Rutgers EJ, Peeters PH. Lokale recidieven na operatie voor borstkanker: Verbetering in recente jaren. [The value of ipsilateral breast tumor recurrence as a quality indicator: hospital variation in the Netherlands]. Ned Tijdschr Geneeskd. 2016;160:A9572. Dutch. PMID: 26813014.
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Ned Tijdschr Geneeskd. 2016;160:A9572.

[The value of ipsilateral breast tumor recurrence as a quality indicator: hospital variation in the Netherlands].

Nederlands tijdschrift voor geneeskunde

[Article in Dutch]
Margriet van der Heiden-van der Loo, Sabine Siesling, Michel W J M Wouters, Thijs van Dalen, Emiel J T Rutgers, Petra H M Peeters

Affiliations

  1. *Dit onderzoek werd eerder gepubliceerd in Annals of Surgical Oncology (2015;(suppl 3):522-8) met als titel 'The value of ipsilateral breast tumor recurrence as a quality indicator: hospital variation in the Netherlands'. Afgedrukt met toestemming.

PMID: 26813014

Abstract

OBJECTIVE: All Dutch hospitals are obliged to report their 5-year ipsilateral breast tumor recurrence (IBTR) rate after breast cancer surgery. Experts decided that these rates should not exceed 5%. This study determined the value of IBTR as an indicator to compare quality of care between hospitals.

DESIGN: Cohort study

METHOD: All patients with breast cancer (pT1-3, any N, M0) who underwent surgery in 1 of 92 Dutch hospitals from 2003 to 2006 were identified in the Netherlands Cancer Registry. Data of recurrence was retrieved from hospital records. Five-year IBTR rates for breast-conserving surgery (BCS) and mastectomy were calculated using the Kaplan-Meier method. Hospital variation was presented in funnel plots . Multivariate analysis was used to assess hospital characteristics associated with IBTR rates.

RESULT: A total of 40,892 breast cancer patients were included. The overall 5-year IBTR rate was 2.85% (95%-CI 2.68-3.03) and was significantly lower for BCS than for mastectomy (2.38% vs 3.45%, p < 0.001). IBTR rates decreased over time in both groups. Rates varied between 0.77 and 5.70% between hospitals. When random variation is taken into account, only extremely high IBTR rates can be detected as deviant from the target value of 5%. Adjusting for tumor and patient characteristics, analyses showed that a higher volume of mastectomies is associated with lower IBTR rates.

CONCLUSION: Our population-based findings show that IBTR rates in the Netherlands are low and have improved over time. The 5-year IBTR rate as an indicator for quality of care of individual hospitals is of limited value.

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