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. 2023 May 30;408(1):218.
doi: 10.1007/s00423-023-02949-7.

Textbook outcome in colon carcinoma: implications for overall survival and disease-free survival

Juan Jesús Rubio García  1   2   3 , F Mauri Barberá  1 , C Villodre Tudela  1   2 , S Carbonell Morote  1   2 , A I Fábregues Olea  1   2 , C Alcázar López  1   2 , C Llopis Torremocha  1   2 , J Ruiz López  1 , A Gomis Martín  1   2 , M Romero Simo  1   2   4 , J M Ramia-Ángel  1   2   4
Affiliations

Textbook outcome in colon carcinoma: implications for overall survival and disease-free survival

Juan Jesús Rubio García et al. Langenbecks Arch Surg. .

Abstract

Background: Textbook outcome (TO) is a multidimensional quality management tool that uses a set of traditional surgical measures to reflect an "ideal" surgical result for a particular pathology. The aim of the present study is to record the rate of TO in patients undergoing elective surgery for colon cancer (CC).

Material and methods: Retrospective study of all patients undergoing scheduled CC surgery at a Spanish university hospital from September 2012 to August 2016. Patients with rectal cancer were excluded. The variables included in the definition of TO were: R0 resection, number of isolated nodes ≥ 12, no Clavien-Dindo ≥ IIIa complications, no prolonged stay, no readmissions, and no mortality in the first 30 days. The main objective of this study is to analyse the achievement of TO in these patients and to assess the relationship between TO and overall and disease-free survival.

Results: Five hundred and sixty-four patients were included in the study. TO was achieved in 49.8%. The sample had a mean age of 69 ± 11 years, and 60% were male. Female sex (OR 1.61; 95% CI 2.30-1.13), T3 and T4 classification (OR 2.50, 95% CI 4.59-1.36, and OR 2.55, 95% CI 5.21-1.24 respectively) and laparoscopic approach (OR 1.53, 95% CI 2.33-1.00) were independent factors that were significantly associated with achieving a TO. Patients who achieved TO had higher overall survival (p = 0.008) than those who did not. However, with regard to disease-free survival, no statistically significant differences were found (p = 0.303).

Conclusion: TO is a useful, easy-to-interpret management tool for measuring oncological results and for predicting patient survival.

Keywords: Colon cancer; Colon carcinoma; Textbook outcome.

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References

    1. Cabadas Avión R (2015) La calidad asistencial: ¿de qué estamos hablando? Quality care: what are we speaking about? Formación Continuada. Cir May Amb 20(2):79–82. Available from: www.asecma.org
    1. Kolfschoten NE, Kievit J, Gooiker GA, Van Leersum NJ, Snijders HS, Eddes EH et al (2013) Focusing on desired outcomes of care after colon cancer resections; hospital variations in “textbook outcome.” Eur J Surg Oncol 39(2):156–63. Available from: https://pubmed.ncbi.nlm.nih.gov/23102705/
    1. Sweigert PJ, Eguia E, Baker MS, Link CM, Hyer JM, Paredes AZ et al (2020) Assessment of cancer center variation in textbook oncologic outcomes following colectomy for adenocarcinoma. J Gastrointest Surg 25(3):775–85. Available from: https://link.springer.com/article/10.1007/s11605-020-04767-4
    1. Yang CC, Tian YF, Liu WS, Chou CL, Cheng LC, Chu SS et al (2020) The association between the composite quality measure “textbook outcome” and long term survival in operated colon cancer. Medicine (Baltimore) 99(40):e22447. Available from: https://pubmed.ncbi.nlm.nih.gov/33019430/
    1. Aquina CT, Hamad A, Becerra AZ, Cloyd JM, Tsung A, Pawlik TM et al (2021) Is textbook oncologic outcome a valid hospital-quality metric after high-risk surgical oncology procedures? Ann Surg Oncol 28(13):8028–45. Available from: https://link.springer.com/article/10.1245/s10434-021-10478-0

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