Table 1.

Sampling of Audit Items

Patient Identification

TNM Staging on Chart?

Diagnostic:

Pathology/biopsy, colonoscopy, CBC, chemistry profile, CEA, abdominal/pelvic CT, CXR (Chest CT OK)

Colonoscopy/sigmoidoscopy on chart?

Did colonoscopy reach to level of cecum?

Pathology report on chart?

Was lymph node dissection ≥ 12 lymph nodes?

Number positive nodes

Number total nodes

Final margin status (≤ 1mm, 1–2mm, ≥ 2 mm)

Radial margin status identified?

Type of Adjuvant Treatment and Number of Cycles:

1) 5-FU bolus with leucovorin (Roswell Park regimen)

2) 5-FU bolus with leucovorin (Mayo Clinic Regimen)

3) Infusional 5-FU (De Gramont Regimen)

4) Capecitabine

5) FOLFOX (oxaliplatin, infusional 5-fluorouracil, bolus 5-FU, leucovorin)

6) FLOX (oxaliplatin, bolus 5-FU, leucovorin)

7) CAPOX (capecitabine plus oxaliplatin)

8) Irinotecan

9) FOLFIRI (infusional 5-FU, irinotecan, leucovorin)

10) IFL (irinotecan, bolus 5-FU, leucovorin):

11) Other

Start of Therapy______________

Stop Date Therapy______________

If Oxaliplatin Not Used, Reason Given?

1) Age

2) Comorbidities

3) Preexisting neuropathy

4) Patient preference

5) Performance status

6) Other (specify)____________________________________

Comorbidities documented? Yes/no and which?

Assessment of Life Expectancy Documented Before Initiating Adjuvant Therapy?

Activities of Daily Living Documented Pretreatment?

Surveillance Documented?

Should Include from Point of Last Treatment:

a. ≤ Q 3 months ± 1 month = H&P for 2 years then ± every 6 months ± 1 month for 5 years.

b. CEA ≤ every 3 months ± 1 month for 2 years then ± every 6 months ± 1 month up to 5 years.

c. CT performed during surveillance?

d. Reason for CT documented?