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

Rubio-García, Juan Jesús; Barberá, F Mauri; Tudela, C. Villodre; Morote, Silvia Carbonell; Olea, Ana Isabel Fábregues; López, Cándido Alcázar; Torremocha, C. Llopis; López, J. Ruiz; Martín, Álvaro Gomis; Simó, Manuel Romero; Ramia-Ángel, José Manuel

doi:10.1007/s00423-023-02949-7

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…The main characteristics of the included studies are shown in Table 1[6,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23]. Twelve studies (70.6%) have been published in the last 3 years and 94.1% in the last 5 years.…”

Section: Resultsmentioning

confidence: 99%

Assessing quality improvement through textbook outcomes in colorectal surgery: A systematic review.

Luis,

Zutoia,

Janine

et al. 2023

Preprint

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In recent years, an increasing interest about the evaluation and quality improvement have grown. Textbook outcome (TO) is a composite measure of several clinically important perioperative outcomes that are included in the definition of the ideal surgical care. The aim of this study is to evaluate and summarize the different definitions concerning textbook outcome in colorectal surgery. A systematic review of the literature according to PRISMA guidelines was carried out until August 2023. Primary studies on adult patients undergoing colon or rectal resection and assessing the textbook outcomes of the procedure were included. Seventeen studies were included for review. The percentage of TO achieved varied from 43–80.8%. The most prevalent variable were “no complications”, “no mortality” and “length of stay”, present in 14 studies (82.4%). The variable that contributed mostly to not meeting the definition of textbook outcome was “no complications” (41.2%) with 6 possible definitions. Other variables that were evaluated were: “readmission”, “radical resection” and “successful lymphadenectomy”. Textbook outcome is an easy-to-interpret quality assessment tool that allows monitoring and comparison of performance improvement. At the same time provide a more meaningful metric of care than individual parameters. As a result of the variability described in this systematic review, a consensus is to be reached in order to validate the extension of this tool in the area of colorectal surgery.

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Section: Resultsmentioning

confidence: 99%

Assessing quality improvement through textbook outcomes in colorectal surgery: A systematic review.

Luis,

Zutoia,

Janine

et al. 2023

Preprint

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“…However, it has not yet been validated whether TO can impact the long-term prognosis of malignant tumors, particularly in the context of pancreatic cancer treatment. Existing research shows that achieving a TO is beneficial for improving the RFS and OS of patients with gastric and colon cancers ( 32 , 33 ). Nevertheless, the criteria for achieving TO in curative surgery for gastric and colon cancers include pathological parameters, such as the adequacy of dissected lymph nodes and achievement of R0 resection, however, it is well-known that pathological parameters are associated with long-term prognosis for cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Association of textbook outcomes with improved survival in pancreatic ductal adenocarcinoma following pancreaticoduodenectomy: a retrospective study

Wang,

Hu,

Yin

et al. 2024

Transl Gastroenterol Hepatol

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Background Assessing the perioperative outcomes of pancreaticoduodenectomy (PD) based solely on individual complications is not comprehensive, and the association between perioperative outcomes and the long-term prognosis of individuals diagnosed with pancreatic ductal adenocarcinoma (PDAC) remains uncertain. Our study is designed to evaluate the impact of a novel composite indicator, textbook outcomes (TO), on the long-term prognosis of patients undergoing PD for PDAC. Methods This study conducted a retrospective analysis of 139 patients who underwent PD for pathologically confirmed PDAC at our hospital between January 2018 and December 2021. After applying exclusion criteria, a total of 111 patients were included in the subsequent analysis. These patients were categorized into two groups: the non-TO group (n=42) and the TO group (n=69). The Kaplan-Meier survival curve was employed to describe the relationship between TO and disease-free survival (DFS) and overall survival (OS). Cox regression was employed to assess the impact of achieving TO on long-term survival. Logistic regression was employed to investigate the risk factors affecting the achievement of TO. Results Out of the 111 PDAC patients, 69 (62.2%) achieved TO following PD. The achievement of TO significantly improved the OS of PDAC patients [P=0.03; hazard ratio (HR) =0.60; 95% confidence interval (CI): 0.37–0.83]. Cox regression analysis indicated that achieving TO was a protective factor for OS (P=0.04; HR =4.08; 95% CI: 1.07–15.61). Logistic regression analysis indicated that high amylase in drainage fluid on the third day after surgery (>1,300 U/L) was detrimental to achieve TO [odds ratio (OR) =0.10; 95% CI: 0.02–0.58; P=0.01], longer surgery durations (≥6.25 hours) was detrimental to achieve TO (OR =0.19; 95% CI: 0.06–0.54; P=0.002), and soft pancreatic texture was detrimental to achieve TO (OR =0.31; 95% CI: 0.10–0.93, P=0.04). Conclusions Achievement of TO significantly improves the OS of PDAC patients and has the potential to serve as a robust prognostic indicator. Looking ahead, it is highly necessary for TO to become a standard surgical quality control measure in hospitals.

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“…There has been a recent increase in interest in the use of Textbook Outcomes (TOs) for elective surgery, including colorectal 1 , oesophagogastric 2 , bariatric 3 , hepatobiliary 4 , gynaecological 5 and cardiac 6 surgery. These TOs are composite outcome measures that seek to better describe the ‘ideal’ outcome for patients.…”

Section: Introductionmentioning

confidence: 99%

Novel Textbook Outcomes following emergency laparotomy: Delphi exercise

Naumann,

Bhangu,

Brooks

et al. 2024

BJS Open

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Background Textbook outcomes are composite outcome measures that reflect the ideal overall experience for patients. There are many of these in the elective surgery literature but no textbook outcomes have been proposed for patients following emergency laparotomy. The aim was to achieve international consensus amongst experts and patients for the best Textbook Outcomes for non-trauma and trauma emergency laparotomy. Methods A modified Delphi exercise was undertaken with three planned rounds to achieve consensus regarding the best Textbook Outcomes based on the category, number and importance (Likert scale of 1–5) of individual outcome measures. There were separate questions for non-trauma and trauma. A patient engagement exercise was undertaken after round 2 to inform the final round. Results A total of 337 participants from 53 countries participated in all three rounds of the exercise. The final Textbook Outcomes were divided into ‘early’ and ‘longer-term’. For non-trauma patients the proposed early Textbook Outcome was ‘Discharged from hospital without serious postoperative complications (Clavien–Dindo ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation or death). For trauma patients it was ‘Discharged from hospital without unexpected transfusion after haemostasis, and no serious postoperative complications (adapted Clavien–Dindo for trauma ≥ grade III; including intra-abdominal sepsis, organ failure, unplanned re-operation on or death)’. The longer-term Textbook Outcome for both non-trauma and trauma was ‘Achieved the early Textbook Outcome, and restoration of baseline quality of life at 1 year’. Conclusion Early and longer-term Textbook Outcomes have been agreed by an international consensus of experts for non-trauma and trauma emergency laparotomy. These now require clinical validation with patient data.

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

Cited by 4 publications

References 24 publications

Assessing quality improvement through textbook outcomes in colorectal surgery: A systematic review.

Assessing quality improvement through textbook outcomes in colorectal surgery: A systematic review.

Association of textbook outcomes with improved survival in pancreatic ductal adenocarcinoma following pancreaticoduodenectomy: a retrospective study

Novel Textbook Outcomes following emergency laparotomy: Delphi exercise

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