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Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival
Background: Colon cancer surgery is a complex clinical pathway and traditional quality metrics may exhibit significant variability between hospitals and healthcare providers. The Textbook Outcome (TO) is a composite quality marker capturing the fraction of patients, in whom all desired short-term ou...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047339/ https://www.ncbi.nlm.nih.gov/pubmed/36975433 http://dx.doi.org/10.3390/curroncol30030220 |
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author | Manatakis, Dimitrios K. Tzardi, Maria Souglakos, John Tsiaoussis, John Agalianos, Christos Kyriazanos, Ioannis D. Pechlivanides, George Kordelas, Athanasios Tasis, Nikolaos Gouvas, Nikolaos Xynos, Evaghelos |
author_facet | Manatakis, Dimitrios K. Tzardi, Maria Souglakos, John Tsiaoussis, John Agalianos, Christos Kyriazanos, Ioannis D. Pechlivanides, George Kordelas, Athanasios Tasis, Nikolaos Gouvas, Nikolaos Xynos, Evaghelos |
author_sort | Manatakis, Dimitrios K. |
collection | PubMed |
description | Background: Colon cancer surgery is a complex clinical pathway and traditional quality metrics may exhibit significant variability between hospitals and healthcare providers. The Textbook Outcome (TO) is a composite quality marker capturing the fraction of patients, in whom all desired short-term outcomes of care are realised. The aim of the present study was to assess the TO in a series of non-metastatic colon cancer patients treated with curative intent, with emphasis on long-term survival. Methods: Stage I–III colon cancer patients, who underwent curative colectomy following the Complete Mesocolic Excision principles, were retrospectively identified from the institutional database. TO was defined as (i) hospital survival, (ii) radical resection, (iii) no major complications, (iv) no reintervention, (v) no unplanned stoma and (vi) no prolonged hospital stay or readmission. Results: In total, 128 patients (male 61%, female 39%, mean age 70.7 ± 11.4 years) were included in the final analysis. Overall, 60.2% achieved a TO. The highest rates were observed for “hospital survival” and “no unplanned stoma” (96.9% and 97.7%), while the lowest rates were for “no major complications” and “no prolonged hospital stay” (69.5% and 75%). Older age, left-sided resections and pT4 tumours were factors limiting the chances of a TO. The 5-year overall and 5-year cancer-specific survival were significantly better in the TO versus non-TO subgroup (81% vs. 59%, p = 0.009, and 86% vs. 65%, p = 0.02, respectively). Conclusions: Outcomes in colon cancer surgery may be affected by patient-, doctor- and hospital-related factors. TO represents those patients who achieve the optimal perioperative results, and is furthermore associated with improved long-term cancer survival. |
format | Online Article Text |
id | pubmed-10047339 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-100473392023-03-29 Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival Manatakis, Dimitrios K. Tzardi, Maria Souglakos, John Tsiaoussis, John Agalianos, Christos Kyriazanos, Ioannis D. Pechlivanides, George Kordelas, Athanasios Tasis, Nikolaos Gouvas, Nikolaos Xynos, Evaghelos Curr Oncol Article Background: Colon cancer surgery is a complex clinical pathway and traditional quality metrics may exhibit significant variability between hospitals and healthcare providers. The Textbook Outcome (TO) is a composite quality marker capturing the fraction of patients, in whom all desired short-term outcomes of care are realised. The aim of the present study was to assess the TO in a series of non-metastatic colon cancer patients treated with curative intent, with emphasis on long-term survival. Methods: Stage I–III colon cancer patients, who underwent curative colectomy following the Complete Mesocolic Excision principles, were retrospectively identified from the institutional database. TO was defined as (i) hospital survival, (ii) radical resection, (iii) no major complications, (iv) no reintervention, (v) no unplanned stoma and (vi) no prolonged hospital stay or readmission. Results: In total, 128 patients (male 61%, female 39%, mean age 70.7 ± 11.4 years) were included in the final analysis. Overall, 60.2% achieved a TO. The highest rates were observed for “hospital survival” and “no unplanned stoma” (96.9% and 97.7%), while the lowest rates were for “no major complications” and “no prolonged hospital stay” (69.5% and 75%). Older age, left-sided resections and pT4 tumours were factors limiting the chances of a TO. The 5-year overall and 5-year cancer-specific survival were significantly better in the TO versus non-TO subgroup (81% vs. 59%, p = 0.009, and 86% vs. 65%, p = 0.02, respectively). Conclusions: Outcomes in colon cancer surgery may be affected by patient-, doctor- and hospital-related factors. TO represents those patients who achieve the optimal perioperative results, and is furthermore associated with improved long-term cancer survival. MDPI 2023-02-28 /pmc/articles/PMC10047339/ /pubmed/36975433 http://dx.doi.org/10.3390/curroncol30030220 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Manatakis, Dimitrios K. Tzardi, Maria Souglakos, John Tsiaoussis, John Agalianos, Christos Kyriazanos, Ioannis D. Pechlivanides, George Kordelas, Athanasios Tasis, Nikolaos Gouvas, Nikolaos Xynos, Evaghelos Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival |
title | Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival |
title_full | Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival |
title_fullStr | Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival |
title_full_unstemmed | Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival |
title_short | Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival |
title_sort | achieving a textbook outcome in colon cancer surgery is associated with improved long-term survival |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10047339/ https://www.ncbi.nlm.nih.gov/pubmed/36975433 http://dx.doi.org/10.3390/curroncol30030220 |
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