直肠癌手术中的环周切缘（CRM）是与局部复发和总体生存率相关的重要预后指标。最近，CRM阳性率被美国癌症委员会（CoC）确立为新的质量指标;然而，对CRM状态报告的完整性尚未得到很好的描述。为描述CRM报告的变化和与报告率低相关的因素，我们进行了一项回顾性队列研究，使用了2010年1月至2019年12月间美国国家癌症数据库的数据。数据分析时间为2021年10月1日至2022年2月1日。美国国家癌症数据库的数据包括在CoC授权的医疗机构接受手术治疗的非转移性直肠腺癌诊断的患者。分析患者、肿瘤和医疗机构层面的因素。根据手术量、公立医院状态和 CoC 机构类型对医疗机构进行划分。环周切缘缺失率。共包括1307所CoC授权医院、110571名（男性占59.3%）接受治愈性手术的直肠腺癌患者纳入分析。研究期间，CRM的报告率有所提高，有缺失率的平均值（标准误）下降了12.0%（0.32%），从16.3%（0.36%）降至。学术医疗机构的缺失率较高于其他机构类型（14.3% vs 10.5%-12.7%，P < .001）。缺失率的均值（标准误）在手术量不同的医院之间相似（四分位数最低：12.2%[0.93%] vs最高：12.4%[0.53%]，P = .96）。移除少于12个淋巴结的病例的缺失率较高（18.1% vs 11.4% ，P < .001）。T分期（比值比[OR]，1.50；95%置信区间[CI]，1.35-1.65）和N分期（OR，2.00；95% CI，1.82-2.20）增加了CRM的缺失几率。黑人种族与CRM的缺失有关（OR，1.13；95% CI，1.06-1.14）。尽管过去十年间CRM阳性率的报告有所改善，但本研究的结果表明，在成为质量标准的过程中，仍然有很大的改进空间。缺失似乎与其他质量指标表现差和机构类型相关。这一指标似乎非常适合用于有针对性的机构级反馈，以改善全国医疗质量。

Circumferential resection margin (CRM) in rectal cancer surgery is a major prognostic indicator associated with local recurrence and overall survival. Facility rates of CRM positivity have recently been established as a new quality measure by the Commission on Cancer (CoC); however, the completeness of CRM status reporting is not well characterized.To describe the changes in CRM reporting and factors associated with low rates of reporting.A retrospective cohort study was conducted using data from the National Cancer Database between January 2010 and December 2019. Data were analyzed between October 1, 2021, and February 1, 2022. Data from the National Cancer Database included patients diagnosed with nonmetastatic rectal adenocarcinoma receiving surgical treatment at CoC-accredited facilities throughout the US.Patient, tumor, and facility-level factors. Facilities were divided by surgical volume, safety-net status, and CoC facility type.Circumferential resection margin missingness rates.A total of 110 571 patients (59.3% men) with rectal adenocarcinoma who underwent curative-intent surgery at 1307 CoC-accredited hospitals were included for analysis. Reporting of CRM improved over the study period, with a mean (SE) missing 12.0% (0.32%) decreased from 16.3% (0.36%). Academic facilities had a higher missingness than other facility types (14.3% vs 10.5%-12.7%; P < .001). Mean (SE) rates of missingness were similar between hospitals of varying volume (lowest quartile: 12.2% [0.93%] vs highest quartile: 12.4% [0.53%]; P = .96). Cases in which fewer than 12 lymph nodes were removed had higher rates of missingness (18.1% vs 11.4%; P < .001). Increased odds of CRM missingness were noted with T category (odds ratio [OR], 1.50; 95% CI, 1.35-1.65) and N category (OR, 2.00; 95% CI, 1.82-2.20). Black race was associated with missingness (OR, 1.13; 95% CI, 1.06-1.14).Although CRM positivity reporting has improved over the last decade, the findings of this study suggest there is substantial room for improvement as it becomes a quality standard. Missingness appears to be associated with poor performance on other quality metrics and facility type. This measure appears to be ideal for targeted institution-level feedback to improve quality of care nationally.