The association between the composite quality measure "textbook outcome" and long term survival in operated colon cancer. Issue 40 (2nd October 2020)

• Record Type: Journal Article
• Authors: Yang, Ching-Chieh; Tian, Yu-Feng; Liu, Wen-Shan; Chou, Chia-Lin; Cheng, Li-Chin; Chu, Shou-Sheng; Lee, Ching-Chih
• Other Names: Bush. Eric section editor.
• Is Part Of: Medicine. Volume 99:Issue 40(2020)
• Publication Date: 2020-10-02
• Subjects: colon cancer -- quality -- surgery -- survival -- textbook outcome; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000022447
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: The aim of this study was to investigate the relationship between textbook outcome and survival in patients with surgically treated colon cancer. A total of 804 surgical cases were enrolled between June 1, 2010 and December 31, 2014. Textbook outcome was defined as patients who had colon cancer surgery and met the six healthcare parameters of surgery within 6 weeks, radical resection, lymph node (LN) yield ≥12, no ostomy, no adverse outcome and colonoscopy before/after surgery within 6 months. The effect of textbook outcome on 5-year disease-specific survival (DSS) was calculated using the Kaplan-Meier method. A Cox regression model was used to find significant independent variables and stratified analysis used to determine whether text-book outcome had a survival benefit. A textbook outcome was achieved in 59.5% of patients undergoing colon cancer surgery. Important obstacles to achieving textbook outcome were no stomy, no adverse outcome and LN yield ≥12. Patients with text-book outcome had statistically significant better 5-year DSS compared to those with-out (80.1% vs. 58.3%). Multivariate analyses indicated that colon cancer patients with textbook outcome had better 5-year DSS after adjusting for various confounders ([aHR], 0.44; 95% CI, 0.34–0.57). Thus, besides being an index of short-term quality of care, textbook outcomes could be used as a prognosticator of long-term outcomes, such as 5-year survival rates. Abstract : Supplemental Digital Content is available in the text