Servicio de Cirugía General y Aparato Digestivo, Hospital General Universitario de Alicante, Alicante, Spain.
Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, Spain.
Langenbecks Arch Surg. 2023 May 30;408(1):218. doi: 10.1007/s00423-023-02949-7.
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).
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.
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).
TO is a useful, easy-to-interpret management tool for measuring oncological results and for predicting patient survival.
教科书结局（Textbook Outcome，TO）是一种多维质量管理工具，它使用一组传统的手术措施来反映特定病理的“理想”手术结果。本研究的目的是记录接受择期结肠癌（CC）手术的患者中达到 TO 的比率。
这是一项对 2012 年 9 月至 2016 年 8 月在西班牙一家大学医院接受预定 CC 手术的所有患者进行的回顾性研究。排除直肠癌症患者。TO 定义中包含的变量包括：R0 切除、孤立淋巴结数≥12 个、无 Clavien-Dindo≥IIIa 级并发症、无住院时间延长、无再入院和 30 天内无死亡。本研究的主要目的是分析这些患者达到 TO 的情况，并评估 TO 与总生存和无病生存之间的关系。
研究共纳入 564 例患者。TO 达到 49.8%。该样本的平均年龄为 69±11 岁，60%为男性。女性性别（OR 1.61；95%CI 2.30-1.13）、T3 和 T4 分类（OR 2.50，95%CI 4.59-1.36 和 OR 2.55，95%CI 5.21-1.24）和腹腔镜方法（OR 1.53，95%CI 2.33-1.00）是与达到 TO 显著相关的独立因素。达到 TO 的患者总生存时间更高（p=0.008），而无病生存时间无统计学差异（p=0.303）。
TO 是一种有用的、易于解释的管理工具，可用于衡量肿瘤学结果并预测患者的生存情况。
