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NCCN Outcomes Databases Track Guidelines Compliance

NCCN Outcomes Databases Track Guidelines Compliance

HOLLYWOOD, Florida—An important part of the cancer guidelines
effort by the National Comprehensive Cancer Network (NCCN), a coalition of 19
major US cancer centers, is to monitor concordance with the guidelines through
the use of outcomes databases. Results from the breast cancer and non-Hodgkin’s
lymphoma databases were presented during the NCCN’s Seventh Annual
Conference.

The breast cancer database includes 7,623 women. "To my knowledge, this
is the largest prospective, comprehensive database on primary breast cancer
patients in the world," said Richard L. Theriault, DO, MBA, professor of
medicine, Department of Breast Medical Oncology, The University of Texas M.D.
Anderson Cancer Center.

The patients all had newly diagnosed breast cancer treated at 11 NCCN
centers from July 1, 1997, through October 16, 2001: 65% were 59 years of age
or younger; 85 patients were under age 30, and 254 were older than age 80. Most
patients (89.43%) had stage 0-II disease.

Dr. Theriault reported a sharp increase in the use of sentinel lymph node
biopsy: from about 13% for stage I-II disease in 1997 to 69% in 1999.

Member institutions had a high rate of breast-conserving surgery for stage I-II disease, but with substantial variability among centers. The
breast-conserving surgery rate was 69% for stage I disease (range, 55% to 82%)
and 48% for stage II disease (range, 34% to 64%), he said.

Most (88%) stage I-II patients treated with breast-conserving surgery
underwent axillary lymph node dissection, and 94% received radiation therapy.
Radiation therapy was more likely to be omitted in women who were elderly
(greater than 80 years of age).

Adjuvant Chemotherapy

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