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...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/30/3/220 |
| _version_ | 1797612511827066880 |
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| author | Dimitrios K. Manatakis Maria Tzardi John Souglakos John Tsiaoussis Christos Agalianos Ioannis D. Kyriazanos George Pechlivanides Athanasios Kordelas Nikolaos Tasis Nikolaos Gouvas Evaghelos Xynos |
| author_facet | Dimitrios K. Manatakis Maria Tzardi John Souglakos John Tsiaoussis Christos Agalianos Ioannis D. Kyriazanos George Pechlivanides Athanasios Kordelas Nikolaos Tasis Nikolaos Gouvas Evaghelos Xynos |
| author_sort | Dimitrios K. Manatakis |
| collection | DOAJ |
| 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%, <i>p</i> = 0.009, and 86% vs. 65%, <i>p</i> = 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. |
| first_indexed | 2024-03-11T06:42:16Z |
| format | Article |
| id | doaj.art-dfb2389469d54b24b93d42e453aadef3 |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-11T06:42:16Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-dfb2389469d54b24b93d42e453aadef32023-11-17T10:30:55ZengMDPI AGCurrent Oncology1198-00521718-77292023-02-013032879288810.3390/curroncol30030220Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term SurvivalDimitrios K. Manatakis0Maria Tzardi1John Souglakos2John Tsiaoussis3Christos Agalianos4Ioannis D. Kyriazanos5George Pechlivanides6Athanasios Kordelas7Nikolaos Tasis8Nikolaos Gouvas9Evaghelos Xynos10Medical School, University of Crete, 71003 Heraklion, GreeceLaboratory of Pathology, Medical School, University of Crete, 71003 Heraklion, GreeceLaboratory of Translational Oncology, Medical School, University of Crete, 71003 Heraklion, GreeceLaboratory of Anatomy, Medical School, University of Crete, 71003 Heraklion, GreeceDepartment of Surgery, Athens Naval and Veterans Hospital, 11521 Athens, GreeceDepartment of Surgery, Athens Naval and Veterans Hospital, 11521 Athens, GreeceDepartment of Surgery, Athens Naval and Veterans Hospital, 11521 Athens, GreeceDepartment of Pathology, Athens Naval and Veterans Hospital, 11521 Athens, GreeceDepartment of Surgery, Athens Naval and Veterans Hospital, 11521 Athens, GreeceMedical School, University of Cyprus, 99010 Nicosia, CyprusColorectal Unit, Creta Interclinic Hospital, 71304 Heraklion, GreeceBackground: 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%, <i>p</i> = 0.009, and 86% vs. 65%, <i>p</i> = 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.https://www.mdpi.com/1718-7729/30/3/220colon cancercolon adenocarcinomatextbook outcomecancer survivalcomplete mesocolic excision |
| spellingShingle | Dimitrios K. Manatakis Maria Tzardi John Souglakos John Tsiaoussis Christos Agalianos Ioannis D. Kyriazanos George Pechlivanides Athanasios Kordelas Nikolaos Tasis Nikolaos Gouvas Evaghelos Xynos Achieving a Textbook Outcome in Colon Cancer Surgery Is Associated with Improved Long-Term Survival Current Oncology colon cancer colon adenocarcinoma textbook outcome cancer survival complete mesocolic excision |
| 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 | colon cancer colon adenocarcinoma textbook outcome cancer survival complete mesocolic excision |
| url | https://www.mdpi.com/1718-7729/30/3/220 |
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