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The Royal Marsden NHS Foundation Trust

The Royal Marsden NHS Foundation Trust incorporates The Royal Marsden Hospital in London https://www.royalmarsden.nhs.uk/

This trust offers the following services:

Diagnostic and pre-operative services:

On-site PET-CT facilities
On-site Cardio-Pulmonary Exercise Testing (CPET) facilities
Routine Genetic Testing for Lynch Syndrome

Surgical services:

On-site hepatobiliary surgical team
Robotic surgery

Advanced disease services:

Dedicated Specialist Advanced Nurse
Dedicated Specialist Advanced MDT
Dedicated Specialist Advanced Outpatient Clinic
Complex vascular reconstruction
Distal sacrectomy
High sacrectomy
Extended lymphadenectomy

Support service facilities:

Availability of 24 hour palliative care advice
7-day access to face-to-face palliative care services

All Patients:	Trust	Network	National
Number of patients in Audit	N/A	1558	35779
Case ascertainment (%)	N/A	Fair	Good

Data completeness of:
– Pre-treatment TNM (%)	N/A	81	86
– Performance status (%)	N/A	78	89

Patients having major resection:	Trust	Network	National
Number of patients in Audit	41	848	19631
ASA grade 1 (%)	2	22	9
ASA grade 2 (%)	78	52	53
ASA grade 3 (%)	12	21	31
ASA grade 4+ (%)	N/A	1	2
ASA grade not recorded (%)	7	4	4

Data completeness of:
7 Audit items for risk-adjustment (%)	93	93	87

Key:

: > 80%

: 50 - 80%

: < 50%

Patients having major resection:	Trust	Network	National
Number of patients in Audit	41	848	19614
Distant metastases (%)	15	6	5
Urgent or emergency surgery (%)	N/A	10	15
At least 12 lymph nodes excised (%)	90	93	84
Laparoscopic surgery attempted (%)	22	63	72
Risk-adjusted length of stay > 5 days (%)	94	74	55

Patients having major resection for stage III colon cancer:	Trust	Network	National
Number of patients in audit	N/A	N/A	10747
Adjuvant chemotherapy (%)	N/A	N/A	62

Patients receiving chemotherapy after major resection for stage III colon cancer:	Trust	Network	National
Number of patients in audit	142	N/A	6608
Severe acute toxicity after adjuvant chemotherapy (%)	15	N/A	22

Patients having major resection:	Trust	Network	National
Number of patients in Audit	18	N/A	4251
Neoadjuvant therapy (%)	84	N/A	33
Circumferential resection margin: Recorded (%)	100	98	89
Circumferential resection margin: Negative (%)	100	94	83
Rectal volume	25	N/A	4377

Patients in APER/Hartmanns estimate:	Trust	Network	National
Number of patients in APER/Hartmanns estimate	100	985	19644
APER/Hartmanns (%)	58	31	37

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