The Validity of Registered Synchronous Peritoneal Metastases from Colorectal Cancer in the Danish Medical Registries
Received 11 November 2019
Accepted for publication 24 February 2020
Published 27 March 2020 Volume 2020:12 Pages 333—343
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Professor Vera Ehrenstein
Sissel Ravn,1 Christian F Christiansen,2 Rikke H Hagemann-Madsen,3 Victor J Verwaal,1 Lene H Iversen1,4
1Department of Surgery, Aarhus University Hospital, Aarhus, Denmark; 2Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 3Department of Pathology, Lillebaelt Hospital, Vejle, Denmark; 4Danish Colorectal Cancer Group (DCCG), Copenhagen, Denmark
Correspondence: Sissel Ravn
Department of Surgery, Aarhus University Hospital, Aarhus N DK-8200, Denmark
Tel +45 51627366
Introduction: Treatment options for peritoneal metastases (PM) from colorectal cancer (CRC) have increased, their efficiency should be monitored. For this purpose, register-based data on PM can be used, if valid.
Purpose: We aimed to evaluate the completeness and positive predictive value (PPV) of synchronous peritoneal metastases (S-PM) registered among CRC patients in the Danish National Patient Register (DNPR) and/or the Danish National Pathology Register (the DNPatR) using the Danish Colorectal Cancer Group database (DCCG) as a reference.
Patients and Methods: We identified Danish patients with newly diagnosed primary CRC in the DCCG during 2014– 2015. S-PM were routinely registered in the DCCG. We excluded patients with non-CRC cancers and identified S-PM using all three registries. We estimated the completeness and the PPV of registered S-PM in the DNPR, the DNPatR and the DNPR and/or the DNPatR (DNPR/DNPatR) in combination using the DCCG as the reference. We stratified by age, gender, WHO performance status, tumour location and distant metastases to liver and/or lungs.
Results: We identified 9142 patients with CRC in DCCG. In DCCG, 366 patients were registered with S-PM, among whom 213 in DCCG only, whereas 153 in DCCG and in at least one of DNPR and/or DNPatR. In DNPR/DNPatR, S-PM was registered with a completeness of 42% [95% CI: 37– 47] and a PPV of 60% [95% CI: 54– 66]. In the DNPR only, the completeness was 32% [95% CI: 27– 37] and the PPV 57% [95% CI: 50– 64]. The completeness in the DNPatR was 19% [95% CI: 15– 23] and the PPV was 76% [95% CI: 68– 85]. In the DNPR/DNPatR patients aged < 60 years (57% [95% CI: 46– 69]), patients with WHO performance status 0 (46% [95% CI: 37– 54]) and patients with no distant metastases (58% [95% CI: 50– 65]) were registered with a higher completeness.
Conclusion: Our algorithm demonstrates that the DNPR/DNPatR captures less than half of CRC patients with S-PM. Potential candidates for curative treatment options are registered with a higher completeness. Clinicians should be encouraged to register the presence of S-PM to increase the validity of register-based S-PM data.
Keywords: validity, synchronous peritoneal metastases, registries, colorectal cancer, epidemiology, completeness
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