Upper GI Cancer - isdscotland.org · 2.4 May 2015 Final Baseline review updates (January 2015) 2,3, 4, 10, 12 . 3 2.5 May 2015 Final Changes Out-with review 3, 6 2.6 June 2015 Final

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Upper GI Cancer

Measurability of Quality Performance Indicators

Version 3.2

To be read in conjunction with:

Upper GI Cancer Clinical Quality Performance Indicators

Upper GI Cancer Data Definitions (Latest published version)

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Measurability of Quality Performance Indicators for Upper GI (OG) Cancer

Please refer to the Upper GI Cancer Quality Performance Indicators published by Healthcare Improvement Scotland for a full description of individual QPIs

Please refer to the Upper GI Cancer QPI Dataset published by ISD Scotland for a full description of individual data items Document control: This version

Title Upper GI Cancer QPI Measurability Version/Issue Number 3.2

Effective From 01 January 2016 (see NB) Author Jane Garrett, ISD

Document Type Guidance Document status Final

Document Purpose To outline how QPIs should be measured using the agreed National Minimum Core Dataset

Summary of changes Baseline review updates

V3.2 May 2018

Final In addition to reporting by Hospital of Diagnosis, the following QPIs should also be reported by Board of Surgery:

QPI 7, 8, 9, 10 (surgery only)

V3.2 May 2018

Final Should also be reported for previous year analysis cohort to ensure complete data QPI 7

Revision History

Version Date Status Summary of Changes QPI (s)

0.1 27/3/2012 Draft Version 1 All

0.2 11/5/2012 Draft Updated for public engagement following comments from Iona Scott All

0.3 7/2/2013 Draft

Updated following public engagement comments, to reflect changes to QPIs and dataset, reformatted to agreed convention as per May 2012 meeting, Not recorded specification updated as agreed with Roger Black Jan 2013, Updated to reflect all QPIs being measured separately for oesophageal and gastric cancers unless otherwise stated

All

0.4 20/2/2013 Draft Updated following Board review comments and finalised for publication 7,9,11

1.0 20/02/2013 Final Version 0.4 saved for publication All

2.0 01/01/2014 Final Amendments made as per agreed changes following 9 month review, updated with new MDT QPI, and checked against published QPIs and dataset

3,12

2.1 Feb 2014 Final Amendments made to QPI 12 to correct issues highlighted via the query service. 10, 12

2.2 June 2014 Final Amendments made out-with review, incorporating additional data item into the dataset updating the MDT QPI.

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2.3 Dec 2014 Final Amendments made outwith review, incorporating changes to QPI 9 9

2.4 Jan 2015 DRAFT Baseline review updates 2,3, 4, 10, 12

2.4 May 2015 Final Baseline review updates (January 2015) 2,3, 4, 10, 12

http://www.healthcareimprovementscotland.org/programmes/cancer_care_improvement/cancer_resources/cancer_qpis.aspx

http://www.isdscotland.org/Health-Topics/Cancer/Cancer-Audit/

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2.5 May 2015 Final Changes Out-with review 3, 6

2.6 June 2015 Final Amendment to QPI 3 outwith review 3

2.7 June 2015 Final Amendment to QPI 3 outwith review 12

3.0 May 2017 Final

Changes made following Formal Review. NB: Formal Review measurability changes apply to patients diagnosed in year 4 data collection (1

st January 2016 – 31

st December 2016) with

the exception of measures which require new data items. These changes will apply to patients diagnosed in year 5 data collection (1

st January 2017-31

st December 2017).

Year 4: 1,2,3,4,7,8,9,10

Year 5: 5,6,11,12,13

3.1 Amendments outwith review 12

3.2 May 2018 Final Amendments outwith review 13

Updates from Previous Version

QPI Summary of changes (excluding formatting changes) (May 2018)

Insertion of two tables (see above)

13 Den: changed from AND [CHEM1 = 4] to [CHEM1 = 4 or 15]

QPI Summary of changes (excluding formatting changes) (June 2017)

12 Inserted ‘or 15’ in Denominator (ii) under Chemotherapy, ‘Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [CHEM1 OR CHEM2 = 4 or 15]’ ‘Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [CHEM1 OR CHEM2 = 4 or 15]

QPI Summary of changes (excluding formatting changes) (April 2017)

1 Description: replaced ‘diagnosis made following initial’ with ‘diagnosis made within 6 weeks of initial’; Numerator: inserted ‘who’, replaced ‘following’ with ‘within 6 weeks of’, removed ‘Date of Initial Investigative Endoscopy equals’ inserted ‘minus Date of Initial Investigative Endoscopy {Cancer} is less than or equal to 42 days – DENDO ≥0 AND ≤ 42 days’

2 QPI 2 – Radiological Staging – REMOVED

3 QPI Title: replaced ‘with newly diagnosed oesophageal or gastric cancer should be discussed’ with ‘should be discussed’; Denominator: removed ‘diagnosed’

4 Description: inserted ‘meeting’ and ‘Please note: The specifications of this QPI are separated to ensure clear measurement of patients who have the following recorded at MDT prior to treatment: I. TNM stage; and II. Treatment Intent; Numerator and Denominator deleted; NR Numerator, NR Exclusion and NR Denominator moved to the end of the calculation.

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QPI Title: replaced ‘referred for dietetic assessment where there are concerns about their nutritional status prior to commencing treatment*’ with ‘appropriately assessed by a dietitian to optimise nutritional status’. ‘are referred to a dietician within 4 weeks of diagnosis’ with ‘undergo nutritional screening before first treatment and are referred to a dietitian where appropriate’, inserted ‘Please note: The specifications of this QPI have been separated to ensure clear measurement of patients who: I. Undergo nutritional screening with the Malnutrition Universal Screening Tool (MUST) before first treatment; AND II. Are at high risk of malnutrition (MUST Score or 2 or more) and are referred to a dietitian.; Numerator: inserted (i), replaced ‘referred to a dietician within 4 weeks of diagnosis’ with ‘who undergo nutritional screening before first treatment’; replaced ‘Date of Referral for Nutritional Assessment MINUS Date of Diagnosis less than or equal to 28 days; AND Date of Referral for Nutritional Assessment NOT coded as Not Applicable - [DDIET – DIAGDATE ≤ 28] AND [DDIET <> 10/10/1010]’ with ‘Date of Nutritional Screening not coded

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as not applicable AND Date of Nutritional Screening less than or equal to Date of First Cancer Treatment OR Date of First Cancer Treatment coded as inapplicable - [NUTSCREENDATE <> 10/10/1010] AND ([NUTSCREENDATE ≤ FIRSTTREATDATE] OR [FIRSTTREATDATE = 10/10/1010])’; Denominator: inserted (i);Inserted ‘Numerator (ii) Number of patients with oesophageal or gastric cancer at high risk of malnutrition (MUST score of 2 or more) who are referred to a dietitian. - Referral to Dietitian coded as Yes - [REFDIET = 1]; Inserted ‘Denominator (ii) All patients with oesophageal or gastric cancer at high risk of malnutrition (MUST score of 2 or more) (No exclusions).- Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour coded as Oesophageal or gastric (presented separately) AND Malnutrition Universal Screening Tool (MUST) coded as 2 or more; - Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [MUST = 2] - Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [MUST = 2]’; NR Numerator: (i) replaced ‘[DDIET = 09/09/0909]’ with ‘[NUTSCREENDATE = 09/09/0909] OR [FIRSTREATDATE = 09/09/0909]’, inserted ‘(ii) [REFDIET = 99]’; NR Denominator: inserted (i) and ‘(ii) [SITE = C99.X] OR [MUST = 99]

6 QPI Title: inserted ‘or chemoradiotherapy’ replaced ‘of chemotherapy portion of treatment plan’ with ‘of this treatment’; Description: inserted ‘or chemoradiotherapy’; Numerator: inserted ‘or chemoradiotherapy’; add ‘1 OR to Oesophageal OPCODE1; Denominator: inserted ‘or chemoradiotherapy’ and ‘or Neoadjuvant chemoradiotherapy – or 12’

7 Denominator: inserted ‘Total gastrectomy OR – 1 OR’, inserted code 7 to Gastric OPCODE1.

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QPI Title: inserted ‘oesophageal’; Description: inserted ‘oesophageal or’, removed ‘curative’; Numerator: inserted ‘oesophageal or; removed ‘curative’; Denominator: inserted ‘oesophageal or’ removed ‘curative’, replaced ‘gastric cancer’ with ‘Oesophageal or gastric (presented separately)’, replaced ‘Partial gastrectomy OR Wedge/localised gastric resection’ with ‘;(for gastric cancers) OR Total gastrectomy OR Right 2 phase sub-total oesophagectomy OR L thoraco-abdominal oesophagectomy (oesophago-gastrectomy) OR McKeown 3 stage sub-total oesophagectomy OR Trans-hiatal oesophagectomy OR Pharynolaryngeal oesphagectomy (for oesophageal cancers) - Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [OPCODE1 = 1 OR 6 OR 7 OR 8 OR 11 OR 17]’, removed ‘OR5 OR 15’ from Gastric and added code 7.

9 QPI Title: replaced ‘gastric surgery’ with ‘gastric cancer’; Description: changed 21 days to 14 days; Numerator: changed 21 days to 14 days also within Length of Stay under Oesophageal and Gastric.

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Description: Inserted the following text ‘Please note: The specifications of this QPI have been separated to ensure clear measurement of both:I. Oesophageal cancer patients who have a clear circumferential margin; and II. Oesophageal and gastric cancer patients who have a clear longitudinal margin; Numerator (i): removed ‘and longitudinal’, removed ‘AND Involvement of Longitudinal Margin {Upper GI Cancer} is coded as no – AND [LMARGIN = 2]’; Denominator (i): inserted ‘Total gastrectomy OR – 1 OR’, inserted ‘OR’ between each OPCODE description; Numerator (ii): inserted ‘oesophageal or’; Denominator (ii): inserted ‘oesophageal or’, ‘or gastric (presented separately), ‘(for gastric cancers) OR Total gastrectomy OR Right 2 phase sub total oesophagectomy OR L thoraco-abdominal oesophagectomy (oesophago-gastrectomy) OR McKeown 3stage sub total oesophagectomy OR Trans-hiatal oesophagectomy OR Pharynolaryngeal oesphagectomy (for oesophageal cancers) - Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [OPCODE1 = 1 OR 6 OR 7 OR 8 OR 11 OR 17]’, ‘Gastric’; inserted code 7 to Gastric OPCODE1. NR Numerator: removed ‘OR [LMARGIN=99]’; Deleted Numerator (i.a), Denominator (i.a), Numerator (i.b) and Denominator (i.b)

11 Numerator: inserted ‘Neoadjuvant’, ‘OR Radical Chemoradiotherapy’ – ’CHEM2 = 12 OR 13’ (for oesophageal and gastric) and ‘OPCODE = 1 OR’. inserted code 7 to Gastric OPCODE1. NR Numerator: inserted ‘OR [FENDO = 99]’

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Amended QPI 12 to ‘30/ 90 Day Mortality Following Oncological Treatment’; QPI Title: inserted ‘and 90’; Description: inserted ‘or 90’; Numerator (i): inserted ‘/90’, under Chemoradiotherapy - amended CHEM1 = 7 to ‘CHEM1 = 12 or 13’, amended ‘CHEM2 = 7’ to ‘CHEM2 = 12 or 13’, amended ‘RADIOTYPE1 = 7’ to ‘RADIOTYPE1 = 8 or 9’, amended ‘RADIOTYPE2 = 7’ to ‘RADIOTYPE2 = 8 or 9’, inserted 90 day mortality equation – ‘( ([CHEM1 = 12 or 13] AND [DOD - CHEMENDATE1 ≤ 90] AND [CHEMENDATE1 <> 10/10/1010] ) OR ([CHEM2 = 12 or 13] AND [DOD – CHEMENDATE2 ≤ 90] AND [CHEMENDATE2 <> 10/10/1010] ) OR ([RADIOTYPE1 = 8 or 9] AND [DOD – RCOMPDATE1 ≤ 90] AND [RCOMPDATE1 <> 10/10/1010] ) OR ([RADIOTYPE2 = 8 or 9] AND [DOD – RCOMPDATE2 ≤ 90] AND [RCOMPDATE2 <> 10/10/1010] ) ) AND [DOD <> 10/10/1010]’, under Peri operative chemotherapy inserted 90 day mortality equation ‘( ([CHEM1 = 1 OR 2 OR11] AND [DOD - CHEMENDATE1 ≤ 90] AND [CHEMENDATE1 <> 10/10/1010] ) OR ([CHEM2 = 1 OR 2 OR 11] AND [DOD – CHEMENDATE2 ≤ 90] AND [CHEMENDATE2 <> 10/10/1010] ) ) AND [DOD <> 10/10/1010]’; Denominator (i): (Chemoradiotherapy) inserted ‘Neoadjuvant’, ‘or Radical chemoradiotherapy’, amended ‘CHEM1 or CHEM2 = 7’ to ‘CHEM1 or CHEM2 = 12 or 13’, amended ‘RADIOTYPE2 = 7’ to ‘RADIOTYPE2 = 8 or 9’. Numerator (ii) amend ‘CHEM1 = 4’ to ‘CHEM1 = 4 or 15’ and ‘CHEM2 = 4’ to ‘CHEM1 = 4 or 15’. (Gastric) amended ‘CHEM1 or CHEM2 = 7’ to ‘CHEM1 or CHEM2 = 12 or 13’, amended ‘RADIOTYPE2 = 7’ to ‘RADIOTYPE2 = 8 or 9’.

13 Inserted New QPI – HER2 Status for Decision Making in Advanced Gastric and Gastro-oesophageal Junction Cancer

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Num add under Chemoradiotherapy - ([CHEM1 = 7] AND, ([CHEM2 = 7] AND, [RADIOTYPE1 = 7] AND, [RADIOTYPE2 = 7] AND; add under Peri operative chemotherapy - [CHEM1 = 1 OR 2 OR11] AND, [CHEM2 = 1 OR 2 OR 11] AND. Den delete - OR Radiotherapy Course Type 1-2 {Upper GI Cancer} coded as chemoradiotherapy, add Radiotherapy Course Type 1-2 {Upper GI Cancer} coded as chemoradiotherapy OR Type of Systemic Anti-Cancer Therapy (SACT) (1-2) {Upper GI Cancer} coded as chemoradiotherapy; OR. Num add [CHEM1 = 4] AND, [CHEM2 = 4] AND


3 Numerator amended to [MDTDATE <> 10/10/1010] AND ([MDTDATE ≤ DEFTREATDATE] OR [DEFTREATDATE = 10/10/1010]


3 Inserted correct text into Numerator - Date Discussed by Care Team (MDT) not coded as not applicable AND Date Discussed by Care Team (MDT) less than or equal to Date of Definitive Treatment OR Date of Definitive Treatment equal to not applicable

6 Inserted OPCODE7 to Numerator - Gastric


2 Remove references to ‘complete’, ‘contrast enhanced’ and update wording to ‘+/- chest +/- pelvis’ and add ‘4’ to numerator

4 Delete ‘either palliative or radical’ plus additional reporting breakdown added

3 Update MDT numerator to exclude not applicable

10 Additional reporting breakdown added

12 Removed reference to 90 days and ‘adjuvant’

QPI Summary of changes (excluding formatting changes) (December 2014)

9 Replaced calculation with SMR01 calculation which has been used already for 1st

year data analysis


3 Amended MDT QPI

QPI Summary of changes (excluding formatting changes) (February 2014)

3 New MDT QPI.

4 Previously QPI 3

5 Previously QPI 4

6 Previously QPI 5

7 Previously QPI 6

8 Previously QPI 7

9 Previously QPI 8

10 Previously QPI 9 - Denominator and Not Recorded updated to correct misspelling of ‘OPCODE1’.

11 Previously QPI 10

12 Previously QPI 11 - Corrections to field names in numerator and included RADIOTYPE2 within denominator.

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QPI 1: Endoscopy

QPI Title:

Patients with oesophageal or gastric cancer should undergo endoscopy and biopsy to reach a diagnosis of cancer.

Description:

Proportion of patients with oesophageal or gastric cancer who have a histological diagnosis made within 6 weeks of initial endoscopy and biopsy.

Numerator: Number of patients with oesophageal or gastric cancer who undergo endoscopy who have a histological diagnosis made within 6 weeks of initial endoscopy and biopsy. Date of Histological Diagnosis minus Date of Initial Investigative Endoscopy {Cancer} is greater or equal to zero and less than or equal to 42 days. [HDIAG – DENDO ≥ 0 AND ≤ 42 days]

Denominator: All patients with oesophageal or gastric cancer who undergo endoscopy (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour coded as Oesophageal or gastric (presented separately); AND Date of Initial Investigative Endoscopy NOT coded as Not Applicable Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [DENDO <> 10/10/1010] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [DENDO <> 10/10/1010 ]

Not recorded for numerator

Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [HDIAG = 09/09/0909] *NB Patients not recorded for DENDO will have been excluded from the denominator

Not recorded for exclusion

Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. N/A

Not recorded for denominator

Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [SITE = C99.X] OR [DENDO = 09/09/0909]

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QPI 3: Multi-Disciplinary Team Meeting (MDT)

QPI Title: Patients should be discussed by a multi-disciplinary team prior to definitive treatment.

Description: Proportion of patients with oesophageal or gastric cancer who are discussed at MDT meeting before definitive treatment.

Numerator Number of patients with oesophageal or gastric cancer discussed at the MDT before definitive treatment. Date Discussed by Care Team (MDT) not coded as not applicable AND Date Discussed by Care Team (MDT) less than or equal to Date of Definitive Treatment OR Date of Definitive Treatment equal to not applicable [MDTDATE <> 10/10/1010] AND ([MDTDATE ≤ DEFTREATDATE] OR [DEFTREATDATE = 10/10/1010])

Denominator All patients with oesophageal or gastric cancer (excluding patients who died before first treatment). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND ‘Site of Origin of Primary Tumour’ coded as oesophageal or gastric cancer; AND ‘Date of First Cancer Treatment’ before ‘Date of Death’. Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [FIRSTTREATMODE <> 94] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C165 OR C166 OR C168 OR C169] AND [FIRSTTREATMODE <> 94]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [MDTDATE = 09/09/0909] OR [DEFTREATDATE = 09/09/0909]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. [FIRSTTREATMODE = 99]


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [SITE = C99X]

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QPI 4: Staging and treatment intent

QPI Title:

Patients with oesophageal or gastric cancer should be staged using the TNM staging system and have statement of treatment intent recorded prior to treatment commencing.

Description:

Proportion of patients with oesophageal or gastric cancer who have TNM stage and treatment intent recorded at MDT meeting prior to treatment. Please note: The specifications of this QPI are separated to ensure clear measurement of patients who have the following recorded at MDT prior to treatment:

I. TNM stage; and II. Treatment Intent

Numerator (i): Number of patients with oesophageal or gastric cancer who have TNM stage recorded at MDT meeting prior to treatment. TNM Tumour Classification (Clinical) {Upper GI Cancer} (Pre-treatment) NOT coded as T Classification Not applicable, or T Classification Not recorded/; AND TNM Nodal Classification (Clinical) {Upper GI Cancer} (Pre-treatment) NOT coded as N Classification Not applicable, or N Classification Not recorded/, AND TNM Metastases Classification (Clinical) {Upper GI Cancer} (Pre-treatment) not coded as M Classification Not applicable, or M Classification Not recorded/. [cT <> 96 OR 99] AND [cN <> 96 OR 99] AND [cM <> 96 OR 99]

Denominator (i): All patients with oesophageal or gastric cancer (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour {Cancer} coded as Oesophageal or gastric (presented separately) Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169]

Numerator (ii): Number of patients with oesophageal or gastric cancer who have treatment intent recorded at MDT meeting prior to treatment. Treatment Intent Recorded at MDT coded as Radical or Palliative or Supportive care or Other [INTENT = 2 OR 3 OR 4 OR 98]

Denominator (ii): All patients with oesophageal or gastric cancer (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour {Cancer} coded as Oesophageal or gastric (presented separately) Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169]

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Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target. N/A (QPI measuring recorded v’s not recorded therefore not recorded included as those not having met the numerator).




Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [SITE = C99.X]

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QPI 5: Nutritional Assessment

QPI Title:

Patients with oesophageal or gastric cancer should be appropriately assessed by a dietician to optimise nutritional status.

Description:

Proportion of patients with oesophageal or gastric cancer who undergo nutritional screening before first treatment and are referred to a dietitian where appropriate. Please note: The specifications of this QPI have been separated to ensure clear measurement of patients who:

I. Undergo nutritional screening with the Malnutrition Universal Screening Tool (MUST) before first treatment; AND II. Are at high risk of malnutrition (MUST Score or 2 or more) and are referred to a dietitian.

Numerator (i): Number of patients with oesophageal or gastric cancer who undergo nutritional screening before first treatment, Date of Nutritional Screening not coded as not applicable AND Date of Nutritional Screening less than or equal to Date of First Cancer Treatment OR Date of First Cancer Treatment coded as inapplicable [NUTSCREENDATE <> 10/10/1010] AND ([NUTSCREENDATE ≤ FIRSTTREATDATE] OR [FIRSTTREATDATE = 10/10/1010])

Denominator (i): All patients with oesophageal or gastric cancer (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour coded as Oesophageal or gastric (presented separately); Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169]

Numerator (ii): Number of patients with oesophageal or gastric cancer at high risk of malnutrition (MUST score of 2 or more) who are referred to a dietitian. Referral to Dietitian coded as Yes [REFDIET = 1]

Denominator (ii) All patients with oesophageal or gastric cancer at high risk of malnutrition (MUST score of 2 or more) (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour coded as Oesophageal or gastric (presented separately) AND Malnutrition Universal Screening Tool (MUST) coded as 2 or more; Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [MUST = 2] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [MUST = 2]

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Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target

(i) [NUTSCREENDATE = 09/09/0909] OR [FIRSTTREATDATE = 09/09/0909] (ii) [REFDIET = 99]




Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard

(i) [SITE = C99.X] (ii) [SITE = C99.X] OR [MUST = 99]

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QPI 6: Appropriate selection of surgical patients

QPI Title: Patients with oesophageal or gastric cancer whose treatment plan is neoadjuvant chemotherapy or chemoradiotherapy followed by surgery should progress to surgery following completion of this treatment.

Description: Proportion of patients with oesophageal or gastric cancer who receive neo-adjuvant chemotherapy or chemoradiotherapy who then go on to have surgical resection.

Numerator:

Number of patients with oesophageal or gastric cancer who receive neo-adjuvant chemotherapy or chemoradiotherapy who then undergo surgical resection. Main Type of Definitive Operation {Upper GI Cancer} coded as Total gastrectomy OR Sub total gastrectomy OR Completion gastrectomy OR Partial gastrectomy OR Wedge/localised gastric resection; OR Right 2 phase sub total oesophagectomy OR L thoraco-abdominal oesophagectomy (oesophago-gastrectomy) OR McKeown 3 stage sub total oesophagectomy OR Trans-hiatal oesophagectomy OR Pharynolaryngeal Oesphagectomy) Oesophageal: [OPCODE1 = 1 OR 6 OR 7 OR 8 OR 11 OR 17] Gastric: [OPCODE1 = 1 OR 2 OR 3 OR 5 OR 7 OR 15]

Denominator: All patients with oesophageal or gastric cancer who receive neo-adjuvant chemotherapy or chemoradiotherapy. (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour coded as Oesophageal or gastric (presented separately); AND Type of Systemic Anti-Cancer Therapy (SACT) (1) {Upper GI Cancer} coded as Neoadjuvant or Neoadjuvant chemoradiotherapy Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [CHEM1 = 2 or 12] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [CHEM1 = 2 or 12]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [OPCODE1 = 99]




Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [SITE = C99.X] OR [CHEM1 = 99]

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QPI 7: 30/90 Day Mortality Following Surgery

QPI Title: 30 and 90 day mortality following surgical resection for oesophageal or gastric cancer

Description: Proportion of patients with oesophageal or gastric cancer who die within 30 or 90 days of surgical resection for oesophageal or gastric cancer.

Numerator:

Number of patients with oesophageal or gastric cancer who undergo surgical resection who die within 30/90 days of treatment 30 Day mortality: Date of Death minus Date of Definitive Surgery less than or equal to 30 days; AND Date of death not coded as Not Applicable [DOD – DSURG ≤ 30] AND [DOD <> 10/10/1010]

90 Day mortality: Date of Death minus Date of Definitive Surgery less than or equal to 90 days; AND Date of death not coded as Not Applicable [DOD – DSURG ≤ 90] AND [DOD <> 10/10/1010]

Denominator: All patients with oesophageal or gastric cancer who undergo surgical resection. (No exclusions) Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour {Cancer} coded as Oesophageal or gastric (presented separately); AND Main Type of Definitive Operation {Upper GI Cancer} coded as Total gastrectomy OR Sub total gastrectomy OR Completion gastrectomy OR Partial gastrectomy OR Wedge/localised gastric resection; (for gastric cancers) OR Total gastrectomy OR Right 2 phase sub total oesophagectomy OR L thoraco-abdominal oesophagectomy (oesophago-gastrectomy) OR McKeown 3 stage sub total oesophagectomy OR Trans-hiatal oesophagectomy OR Pharynolaryngeal oesphagectomy (for oesophageal cancers) Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [OPCODE1 = 1 OR 6 OR 7 OR 8 OR 11 OR 17] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [OPCODE1 = 1 OR 2 OR 3 OR 5 OR 7 OR 15]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [DOD = 09/09/0909] OR [DSURG = 09/09/0909]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this

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standard. N/A


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [SITE = C99.X] OR [OPCODE1 = 99]

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QPI 8: Lymph node yield

QPI Title:

For patients with oesophageal or gastric cancer undergoing curative resection the number of lymph nodes examined should be maximised.

Description: Proportion of patients with oesophageal or gastric cancer who undergo surgical resection where ≥15 lymph nodes are resected and pathologically examined.

Numerator:

Number of patients with oesophageal or gastric cancer who undergo surgical resection where ≥15 lymph nodes are resected and pathologically examined. Total Number of Lymph Nodes Examined Microscopically greater than or equal to 15

[EXNODES ≥ 15]

Denominator: All patients with oesophageal or gastric cancer who undergo surgical resection (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour {Cancer} coded as Oesophageal or gastric (presented separately); AND Main Type of Definitive Operation {Upper GI Cancer} coded as Total gastrectomy OR Sub total gastrectomy OR Completion gastrectomy (for gastric cancers) OR Total gastrectomy OR Right 2 phase sub total oesophagectomy OR L thoraco-abdominal oesophagectomy (oesophago-gastrectomy) OR McKeown 3 stage sub total oesophagectomy OR Trans-hiatal oesophagectomy OR Pharynolaryngeal oesphagectomy (for oesophageal cancers). Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [OPCODE1 = 1 OR 6 OR 7 OR 8 OR 11 OR 17] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [OPCODE1 = 1 OR 2 OR 3 OR 7]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target

[EXNODES = 9999]




Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [SITE = C99.X] OR [OPCODE1 = 99]

16

QPI 9: Length of hospital stay QPI Title: Length of hospital stay following surgery for oesophageal or gastric cancer should be as short as possible.

Description: Proportion of patients undergoing surgical resection for oesophageal or gastric cancer who are discharged within 14 days of surgical procedure.

Numerator: Number of patients undergoing surgical resection for oesophageal or gastric cancer who are discharged within 14 days of surgical procedure.

Oesophageal Gastric

(CIS end date in time period specified) (CIS end date in time period specified)

AND AND

(Diagnosis1 or Diagnosis2 or Diagnosis3 or Diagnosis4 or Diagnosis5 or Diagnosis6 = {C150 or C151 or C152 or C153 or C154 or C155 or C158 or C159 or C160})

(Diagnosis1 or Diagnosis2 or Diagnosis3 or Diagnosis4 or Diagnosis5 or Diagnosis6 = {C161 or C162 or C163 or C164 or C165 or C166 or C168 or C169})

AND AND

(MainOp or Op1 or Op2 or Op3 = {G011 or G012 or G013 or G018 or G019 or G021 or G022 or G023 or G024 or G025 or G028 or G029 or G031 or G032 or G033 or G034 or G035 or G036 or G038 or G039 or G048 or G049 or G271 or G272 or G273 or G274 or G275 or G278 or G279 or G281 or G282 or G283})


AND AND

Length of Stay after earliest relevant operation ≤ 14 days Length of Stay after earliest relevant operation ≤ 14 days

Denominator: All patients undergoing surgical resection for oesophageal or gastric cancer.

Oesophageal Gastric

(CIS end date in time period specified) (CIS end date in time period specified)

AND AND

(Diagnosis1 or Diagnosis2 or Diagnosis3 or Diagnosis4 or Diagnosis5 or Diagnosis6 = {C150 or C151 or C152 or C153 or C154 or C155 or C158 or C159 or C160})

(Diagnosis1 or Diagnosis2 or Diagnosis3 or Diagnosis4 or Diagnosis5 or Diagnosis6 = {C161 or C162 or C163 or C164 or C165 or C166 or C168 or C169})

AND AND



Exclusions: None

17

QPI 10: Resection Margins QPI Title: Oesophageal and gastric cancers which are surgically resected should be adequately excised.

Description:

Proportion of patients with oesophageal or gastric cancer who undergo surgical resection in which surgical margin is clear of tumour, i.e. negative surgical margin. Please note: The specifications of this QPI have been separated to ensure clear measurement of both:

I. Oesophageal cancer patients who have a clear circumferential margin; and II. Oesophageal and gastric cancer patients who have a clear longitudinal margin.

Specification (i) Numerator (i)

Number of patients with oesophageal cancer who undergo surgical resection in which circumferential surgical margin is clear of tumour. Involvement of Circumferential Margin (Oesophageal Cancer only) Is coded as no. [CMARGIN=2]

Denominator (i) All patients with oesophageal cancer who undergo surgical resection (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour {Cancer} coded as Oesophageal; AND Main Type of Definitive Operation {Upper GI Cancer} coded as Total gastrectomy OR Right 2 phase sub total oesophagectomy OR L thoraco-abdominal oesophagectomy (oesophago-gastrectomy) OR McKeown 3 stage sub total oesophagectomy OR Trans-hiatal oesophagectomy ORPharynolaryngeal oesphagectomy [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [OPCODE1 = 1 OR 6 OR 7 OR 8 OR 11 OR 17]

Specification (ii) Numerator (ii) Number of patients with oesophageal or gastric cancer who undergo surgical resection in which longitudinal surgical margin is clear of tumour. Involvement of Longitudinal Margin {Upper GI Cancer} is coded as no [LMARGIN=2]

Denominator (ii) All patients with oesophageal or gastric cancer who undergo surgical resection (No exclusions). Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour {Cancer} coded as Oesophageal or gastric (presented separately); AND Main Type of Definitive Operation {Upper GI Cancer} coded as Total gastrectomy OR Sub total gastrectomy OR Completion gastrectomy OR Partial gastrectomy OR Wedge/localised gastric resection (for gastric cancers) OR Total gastrectomy OR Right 2 phase sub total oesophagectomy OR L thoraco-abdominal oesophagectomy (oesophago-gastrectomy) OR McKeown 3 stage sub total oesophagectomy OR Trans-hiatal

18

oesophagectomy OR Pharynolaryngeal oesphagectomy (for oesophageal cancers) Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [OPCODE1 = 1 OR 6 OR 7 OR 8 OR 11 OR 17] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [OPCODE1 = 1 OR 2 OR 3 OR 5 OR 7 OR 15 ]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target (i) [CMARGIN=99] (ii) [LMARGIN=99]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. (i) and (ii) N/A


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard (i) and (ii) [SITE = C99.X] OR [OPCODE1 = 99]

19

QPI 11 – Curative Treatment Rates

QPI Title:

Patients with oesophageal or gastric cancer should undergo curative treatment whenever possible.

Description:

Proportion of patients with oesophageal or gastric cancer who undergo curative treatment, this includes:

Neoadjuvant chemoradiotherapy or chemotherapy followed by surgery;

Primary surgery;

Radical chemoradiotherapy; and

Endoscopic Mucosal Resection.

Numerator:

Number of patients with oesophageal or gastric cancer who undergo curative treatment. Type of Systemic Anti-Cancer Therapy (SACT) 1-2 coded as Neo-adjuvant OR Neoadjuvant chemoradiotherapy OR Radical Chemoradiotherapy; OR; Main Type of Definitive Operation {Upper GI Cancer} coded as any curative surgery; OR First Endoscopic Treatment coded as Endo-mucosal resection (EMR) Oesophageal: [CHEM1 OR CHEM2 = 2 OR 12 OR 13] OR [FENDO = 6] OR [OPCODE1= 1 OR 6 OR 7 OR 8 OR 11 OR 17] Gastric: [CHEM1 OR CHEM2 = 2 OR 12 OR 13] OR [FENDO = 6] OR [OPCODE1= 1 OR 2 OR 3 OR 5 OR 7 OR 15]

Denominator: All patients with oesophageal or gastric cancer (No exclusions) Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour coded as Oesophageal or gastric (presented separately) Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [OPCODE1 = 99] OR [CHEM1 OR CHEM2 = 99] OR [FENDO = 99]



20


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [SITE = C99.X]

21

QPI 12 – 30 / 90 Day Mortality Following Oncological Treatment

QPI Title: 30 and 90 day mortality following oncological treatment for oesophageal or gastric cancer.

Description: Proportion of patients with oesophageal or gastric cancer who die within 30 or 90 days of oncological treatment for oesophageal or gastric cancer.

Numerator (i): Number of patients with oesophageal or gastric cancer who receive curative oncological treatment who die within 30 / 90 days of treatment. Date of death minus Date Treatment Completed Systemic Anti-Cancer Therapy (SACT) 1-2 OR Date of death minus Date Treatment Completed (Radiotherapy) {Upper GI Cancer} 1-2 (presented separately) less than or equal to 30 / 90 days Chemoradiotherapy 30 day mortality: ( ([CHEM1 = 12 or 13] AND [DOD - CHEMENDATE1 ≤ 30] AND [CHEMENDATE1 <> 10/10/1010] ) OR ([CHEM2 = 12 or 13] AND [DOD – CHEMENDATE2 ≤ 30] AND [CHEMENDATE2 <> 10/10/1010] ) OR ([RADIOTYPE1 = 8 or 9] AND [DOD – RCOMPDATE1 ≤ 30] AND [RCOMPDATE1 <> 10/10/1010] ) OR ([RADIOTYPE2 = 8 or 9] AND [DOD – RCOMPDATE2 ≤ 30] AND [RCOMPDATE2 <> 10/10/1010] ) ) AND [DOD <> 10/10/1010] 90 day mortality: ( ([CHEM1 = 12 or 13] AND [DOD - CHEMENDATE1 ≤ 90] AND [CHEMENDATE1 <> 10/10/1010] ) OR ([CHEM2 = 12 or 13] AND [DOD – CHEMENDATE2 ≤ 90] AND [CHEMENDATE2 <> 10/10/1010] ) OR ([RADIOTYPE1 = 8 or 9] AND [DOD – RCOMPDATE1 ≤ 90] AND [RCOMPDATE1 <> 10/10/1010] ) OR ([RADIOTYPE2 = 8 or 9] AND [DOD – RCOMPDATE2 ≤ 90] AND [RCOMPDATE2 <> 10/10/1010] ) ) AND [DOD <> 10/10/1010] Peri operative chemotherapy 30 day mortality: ( ([CHEM1 = 1 OR 2 OR11] AND [DOD - CHEMENDATE1 ≤ 30] AND [CHEMENDATE1 <> 10/10/1010] ) OR ([CHEM2 = 1 OR 2 OR 11] AND [DOD – CHEMENDATE2 ≤ 30] AND [CHEMENDATE2 <> 10/10/1010] ) ) AND [DOD <> 10/10/1010] 90 day mortality: ( ([CHEM1 = 1 OR 2 OR11] AND [DOD - CHEMENDATE1 ≤ 90] AND [CHEMENDATE1 <> 10/10/1010] ) OR ([CHEM2 = 1 OR 2 OR 11] AND [DOD – CHEMENDATE2 ≤ 90] AND [CHEMENDATE2 <> 10/10/1010] ) ) AND [DOD <> 10/10/1010]

Denominator (i): All patients with oesophageal or gastric cancer who receive curative oncological treatment. (No exclusions) Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour coded as Oesophageal or gastric (presented separately); AND Radiotherapy Course Type 1-2 {Upper GI Cancer} coded as Neoadjuvant chemoradiotherapy or Radical chemoradiotherapy OR Type of Systemic Anti-Cancer Therapy (SACT) (1-2) {Upper GI Cancer} coded as Neoadjuvant chemoradiotherapy or Radical chemoradiotherapy; OR Type of Systemic Anti-Cancer Therapy (SACT) (1-2) {Upper GI Cancer} coded as neoadjuvant, adjuvant or downstaging. Chemoradiotherapy Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND ( [CHEM1 OR CHEM2 = 12 or 13] OR [RADIOTYPE1 OR RADIOTYPE2 = 8 or 9] )

22

Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND ( [CHEM1 OR CHEM2 = 12 or 13] OR [RADIOTYPE1 OR RADIOTYPE2 =8 or 9] ) Peri operative chemotherapy Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [CHEM1 OR CHEM2 = 1 OR 2 OR 11] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [CHEM1 OR CHEM2 = 1 OR 2 or 11]

Numerator (ii): Number of patients with oesophageal or gastric cancer who receive palliative oncological treatment who die within 30 days of treatment. Date of death minus Date Treatment Completed Systemic Anti-Cancer Therapy (SACT) 1-2 OR Date of death minus Date Treatment Completed (Radiotherapy) {Upper GI Cancer} 1-2 (presented separately) less than or equal to 30 days Chemotherapy (Palliative) 30 day mortality: ( ([CHEM1 = 4 or 15] AND [DOD - CHEMENDATE1 ≤ 30] AND [CHEMENDATE1 <> 10/10/1010] ) OR ([CHEM2 = 4 or 15] AND [DOD – CHEMENDATE2 ≤ 30] AND [CHEMENDATE2 <> 10/10/1010] ) ) AND [DOD <> 10/10/1010]

Denominator (ii): All patients with oesophageal or gastric cancer who receive palliative oncological treatment.(No exclusions) Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour coded as Oesophageal or gastric (presented separately); AND (also presented separately) Type of Systemic Anti-Cancer Therapy (SACT) (1-2) {Upper GI Cancer} coded as palliative Chemotherapy Oesophageal: [SITE = C150 OR C151 OR C152 OR C153 OR C154 OR C155 OR C158 OR C159 OR C160] AND [CHEM1 OR CHEM2 = 4 or 15] Gastric: [SITE = C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [CHEM1 OR CHEM2 = 4 or 15]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target (i) Chemoradiotherapy [DOD = 09/09/0909] OR [CHEMENDATE1 OR CHEMENDATE2 = 09/09/0909] OR [RCOMPDATE1 OR RCOMPDATE2 = 09/09/0909] Peri operative chemotherapy [DOD = 09/09/0909] OR [CHEMENDATE1 OR CHEMENDATE2 = 09/09/0909] (ii) Chemotherapy [DOD = 09/09/0909] OR [CHEMENDATE1 OR CHEMENDATE2 = 09/09/0909]


Include in the denominator for measurement against the target unless there is other definitive evidence that the record should be excluded. Present as not recorded only where the record cannot otherwise be definitively identified as an inclusion/exclusion for this standard. (i) and (ii) N/A

23


Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard (i) Chemoradiotherapy [SITE = C99.X] OR [CHEM1 OR CHEM2 = 99] OR [RADIOTYPE = 99] Peri operative chemotherapy [SITE = C99.X] OR [CHEM1 OR CHEM2 = 99] (ii) Chemotherapy [SITE = C99.X] OR [CHEM1 OR CHEM2 = 99]

24

QPI 13 – HER2 Status for Decision Making in Advanced Gastric and Gastro-oesophageal Junction Cancer

QPI Title: HER 2 status should be available to inform treatment decision making in patients with advanced gastric and gastro-oesophageal junction adenocarcinoma

Description: Proportion of patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma undergoing first line palliative chemotherapy as their initial treatment for whom the HER2 status is reported prior to commencing treatment.

Numerator: Number of patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma undergoing first line palliative chemotherapy as their initial treatment for whom the HER2 status is reported prior to commencing treatment. Date of HER2 reporting not coded as not applicable AND Date of HER2 Reporting less than Date Treatment Started Systemic Anti Cancer Therapy [HER2REPORT <> 10/10/1010] AND [HER2REPORT < CHEMDATE1]

Denominator: All patients with metastatic gastric or gastro-oesophageal junction adenocarcinoma undergoing first line palliative chemotherapy as their initial treatment. (No exclusions) Date of Diagnosis [DIAGDATE] in range specified for comparative analysis; AND Site of Origin of Primary Tumour coded as Gastric or Gastro-oesophageal junction; AND TNM Metastases Classification (Clinical) coded as Distant Metastasis; AND Morphology of Tumour coded as Adenocarcinoma; AND Type of Systemic Anti-Cancer Therapy (SACT) (1-2) {Upper GI Cancer} coded as Palliative; AND Type of First Cancer Treatment coded as Systemic Anti-Cancer Therapy (SACT). [SITE = C160 OR C161 OR C162 OR C163 OR C164 OR C165 OR C166 OR C168 OR C169] AND [cM = M1] AND [MORPHOL = 8140/3 OR 8144/3 OR 8145/3 OR 8260/3 OR 8211/3 OR 8480/3 OR 8490/3] AND [CHEM1 = 4 or 15] AND [FIRSTTREATMODE = 3]


Include in the denominator for measurement against the target. Present as not recorded only if the patient cannot otherwise be identified as having met/not met the target [HER2REPORT = 09/09/0909] OR [CHEMDATE1 = 09/09/0909]




Exclude from the denominator for measurement against the target. Present as not recorded only where the patient cannot otherwise be definitively identified as an inclusion/exclusion for this standard [SITE = C99.X] OR [cM = 99] OR [MORPHOL = 9999/9] OR [CHEM1 = 99] OR [FIRSTTREATMODE = 99]

Documents

Upper GI Cancer - isdscotland.org · 2.4 May 2015 Final Baseline review updates (January 2015) 2,3, 4, 10, 12 . 3 2.5 May 2015 Final Changes Out-with review 3, 6 2.6 June 2015 Final