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

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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.

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Authors and Affiliations

  1. Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario de Alicante, Alicante, Spain

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

  2. Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain

    Juan Jesús Rubio García, C. Villodre Tudela, S. Carbonell Morote, A. I. Fábregues Olea, C. Alcázar López, C. Llopis Torremocha, A. Gomis Martín, M. Romero Simo & J. M. Ramia-Ángel

  3. Alicante, Spain

    Juan Jesús Rubio García

  4. Universidad Miguel Hernández, Alicante, Spain

    M. Romero Simo & J. M. Ramia-Ángel

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  1. Juan Jesús Rubio García
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Contributions

Individual contribution of each author: Rubio-García J.J: Conceptualization, data curation, formal analysis, investigation, methodology, writing original draft, writing-review and editing. Mauri Barberá F: Conceptualization, Data curation, Formal analysis, investigation, writing original draft, writing-review and editing. Villodre Tudela C: Conceptualization, data curation, formal analysis, methodology, supervision, writing-review and editing. Carbonell Morote S: Formal analysis, methodology, investigation, resources, validation. Fábregues Olea AI: Formal analysis, methodology, investigation, resources, validation. Alcázar López C: Formal analysis, methodology, investigation, resources, validation. Llopis Torremocha C: Formal analysis, methodology, investigation, resources, validation. Ruiz López J: Formal analysis, methodology, investigation, resources, validation. Gomis Martín A: Formal analysis, methodology, investigation, resources, validation. Romero Simó M: Conceptualization, Methodology, Project administration, Supervision, Validation, project administration Writing-review & editing. Ramia-Angel JM: Conceptualization, Methodology, Project administration, Supervision, Validation, project administration Writing-review & editing.

Ethics declarations

The study was authorized by the Ethics Committee (CEIM) of the public Hospital General Universitario de Alicante (HGUA: nº 2022–103, ISABIAL 2022–0297). The requirement of informed consent was waived due to the retrospective design and the absence of any risk. No information that might identify individual patients was used.

Competing interests

Authors declare no competing interests.

Conflict of interest

The authors declare that they have no conflict of interest.

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The study was registered in the public accessible database clinicaltrials.gov with the ClinicalTrials.gov ID: NCT05675904. Public release date: 01/05/2023.

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Rubio García, J.J., Mauri Barberá, F., Villodre Tudela, C. et al. Textbook outcome in colon carcinoma: implications for overall survival and disease-free survival. Langenbecks Arch Surg 408, 218 (2023). https://doi.org/10.1007/s00423-023-02949-7

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