Textbook outcome,chemotherapy compliance,and prognosis after radical gastrectomy for gastric cancer: A large sample analysis |
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| Institution: | 1. Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China;2. Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China;3. Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China;4. Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China;1. Department of Surgery, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, UK;2. Department of Radiology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, UK;3. Leicester Cancer Research Centre, University of Leicester, UK;1. Digestive and General Surgery, Yalgado Ouedraogo Teaching Hospital Ouagadougou, 03 BP 7021, Ouagadougou, Joseph Ki-Zerbo University, Burkina Faso;2. Institut Joliot Curie de Dakar (Senegal), Cheikh Anta Diop University of Dakar, 10700, Dakar, Senegal;1. Peter MacCallum Cancer Centre, Division of Surgical Oncology, Australia;2. Sir Peter MacCallum Department of Oncology, University of Melbourne, Australia;3. Peter MacCallum Cancer Centre, Department of Molecular Pathology, Australia;4. Peter MacCallum Cancer Centre, Division of Medical Oncology, Australia;1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China;2. Department of Pathology, Peking University Third Hospital, Beijing, 100191, China;3. Peking University Health Information Technology Co. Ltd, Beijing, 100080, China;4. Shanghai Songsheng Business Consulting Co. LTD, Beijing, 100000, China;5. Department of Pathology, Third Hospital, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China;6. Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, 100191, China;7. Institute for Artificial Intelligence, Peking University, Beijing, 100091, China |
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| Abstract: | BackgroundThis study aims to analyze the effect of textbook outcome (TO) on the long-term prognosis and adjuvant chemotherapy (AC) compliance of patients with gastric cancer (GC) in a single institute.Materials and methodsConsecutive patients who underwent radical gastrectomy with pathological stage I-III at Union Hospital of Fujian Medical University from January 2010 to June 2017 were included. TO was defined as receiving a complete-potentially curative status, ≥15 lymph nodes examined, hospital stay ≤21 days, and freedom from intraoperative and postoperative complications, re-intervention in 30 days, 30-day readmission to the hospital or intensive care unit, and 30-day postoperative mortality.ResultsTotally 3993 patients were included, of which 3361 (84.2%) patients achieved TO. The overall, disease-specific, and recurrence-free survival of patients achieving TO were significantly better than those of patients without achieving TO (all P < 0.05). The total number of AC cycles was greater and the interval from surgery to first AC was shorter in the TO group compared with the Non-TO group. Age >65 years old, open surgery, pT3-4 stage, and total radical gastrectomy (TG) were identified as related high-risk factors for failure to achieve TO. Laparoscopic surgery facilitated TO achievement in high-risk groups.ConclusionTO is a reliable indicator of favorable prognosis of patients with GC and contributes to postoperative chemotherapy compliance. Age ≤65 years old, non-TG, pT1-2 stage, and laparoscopic surgery may promote the achievement of TO. |
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| Keywords: | Textbook outcome Prognosis Chemotherapy compliance Gastric cancer |
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