肺癌淋巴结标准5.8的早期依从性：2022年和2023年癌症部位审查委员会的分析

IF 4.4 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Thoracic and Cardiovascular Surgery Pub Date : 2025-10-01 DOI:10.1016/j.jtcvs.2025.04.041

Alison S. Baskin MD , Elizabeth C. Funk MSW , Amanda B. Francescatti MS , Brandy R. Sinco MA, MS , Bryan E. Palis MA , Tina J. Hieken MD, FACS , Matthew H.G. Katz MD, FACS , Judy C. Boughey MD, FACS , Ronald J. Weigel MD, PhD, MBA, FACS , Lesly A. Dossett MD, MPH, FACS , Daniel J. Boffa MD, MBA, FACS

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引用次数: 0

摘要

目的：为了解决治疗意图肺癌切除术中淋巴结分期的变异性，癌症委员会（CoC）于2021年实施了标准5.8，要求从≥3个纵隔站和≥1个肺门站取样淋巴结，并在综合病理报告中记录。我们评估了来自最近站点审查的遵从性数据，通过联邦资助的协作来评估标准5.8的早期实现。方法：从2022年和2023年进行的CoC现场访问的现场评审员文档库中提取符合标准5.8的医院依从率。每次回顾包括多达7个随机选择的符合标准的病理报告。对于符合标准的站点，2022年审查的7份病理报告中必须有5份符合标准5.8，到2023年及以后，7份报告中必须有6份符合标准5.8。结果：总体而言，在2022年和2023年进行了652次实地考察。没有符合条件的病例（n=148, 23%）被排除。在504个符合条件的站点中，272个（54%）符合要求，232个（46%）不符合要求。在不符合标准的部位，病理报告符合标准的中位数百分比为29%。从2022年到2023年，附着病理报告的中位数百分比增加；然而，随着现场合规门槛的提高，2023年的总体合规率有所下降。结论：几乎一半的coc认证部位不符合要求，这是一个真正的机会来提高手术淋巴结评估的质量。这与支持医院和外科医生为标准5.8提供质量改进工具和资源的不断努力相一致。

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Early compliance with lung cancer lymph node standard 5.8: An analysis of 2022 and 2023 Commission on Cancer site reviews

Objective

To address variability in nodal staging during curative-intent lung cancer resections, the Commission on Cancer implemented Standard 5.8 in 2021, requiring lymph nodes be sampled from ≥3 mediastinal stations and ≥1 hilar station and documented in a synoptic pathology report. We assessed compliance data from recent site reviews to evaluate the early implementation of Standard 5.8 through a federally funded collaborative.

Methods

Hospital compliance rates with Standard 5.8 were extracted from a repository of site reviewers’ documentation of Commission on Cancer site visits performed during 2022 and 2023. Each review included up to 7 randomly selected pathology reports eligible for the standard. For a site to be compliant, 5 of 7 pathology reports reviewed in 2022 must have met Standard 5.8, which increased to 6 of 7 reports in 2023 and beyond.

Results

Overall, 652 site visits occurred in 2022 and 2023. Sites without eligible cases (n = 148 [23%]) were excluded. Among 504 eligible sites, 272 (54%) were found compliant, and 232 (46%) were found noncompliant. Of noncompliant sites, the median percentage of pathology reports meeting the standard was 29%. From 2022 to 2023, the median percentage of adherent pathology reports increased; however, overall compliance rates dipped in 2023 as the threshold needed for site compliance rose.

Conclusions

With almost half of Commission on Cancer-accredited sites noncompliant, there is a real opportunity to improve the quality of surgical lymph node evaluations. This aligns with growing efforts to support hospitals and surgeons with quality improvement tools and resources for Standard 5.8.

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来源期刊

Journal of Thoracic and Cardiovascular Surgery 医学-呼吸系统

CiteScore

11.20

自引率

10.00%

发文量

1079

审稿时长

68 days

期刊介绍： The Journal of Thoracic and Cardiovascular Surgery presents original, peer-reviewed articles on diseases of the heart, great vessels, lungs and thorax with emphasis on surgical interventions. An official publication of The American Association for Thoracic Surgery and The Western Thoracic Surgical Association, the Journal focuses on techniques and developments in acquired cardiac surgery, congenital cardiac repair, thoracic procedures, heart and lung transplantation, mechanical circulatory support and other procedures.