Abstract

BACKGROUND AND OBJECTIVES: Composite measures are increasingly used to assess quality of care in surgical oncology. We sought to define the incidence of "textbook oncologic outcome" (TOO) following resection of gastric adenocarcinoma among a large, international cohort of patients.METHODS: Gastric adenocarcinoma patients undergoing resection between 2000 and 2020 were identified from an international database. TOO was defined as margin-negative resection, examination of =16 lymph nodes, no prolonged length-of-stay (LOS), no 30-day mortality, and stage-appropriate receipt of chemotherapy.RESULTS: Among a total of 910 patients, 321 patients (35.3%) achieved a postoperative TOO. While failure to evaluate =16 lymph nodes (n=591, 65.0%) and receipt of chemotherapy (n=651, 71.5%) had the greatest negative impact on the ability to obtain a TOO, no 30-day mortality (n=880, 96.7%), margin-negative resection (n=831, 91.3%), and no extended LOS (n=706, 77.6%) were more commonly achieved. No postoperative complications (OR: 0.44;95% CI:0.31-0.63) and T1a/T1b-stage disease (OR: 2.87;95% CI:1.59-5.18) were independently associated with achieving a TOO (p<0.05). The odds of achieving a TOO improved over time (p-trend<0.05), which was largely attributable to improved odds of evaluating=16 lymph nodes (2010-2014 vs. 2000-2004:OR,5.21;95% CI: 3.22-8.45).CONCLUSIONS: Only about onein threepatients achieved a TOO following resection of gastric adenocarcinoma. Odds of TOO increased over time, largely due to improved lymph node evaluation.

View details for DOI 10.1002/jso.26778

View details for PubMedID 34964983