Evidence map›Paper›PMID 31686260›Full record

ArticleGastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association2020

Gastrectomy case volume and textbook outcome: an analysis of the Population Registry of Esophageal and Stomach Tumours of Ontario (PRESTO).

Jordan Levy, Vaibhav Gupta, Elmira Amirazodi, Catherine Allen-Ayodabo, Naheed Jivraj, Yunni Jeong, Laura E Davis, Alyson L Mahar, Charles De Mestral, Olli Saarela and 2 more

Open access · bronzeAbstract read
PubMed Publisher
In one paragraph

Article in Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 3 pooled it
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 3 syntheses or guidelines pooled it, 53 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
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  5. Textbook outcome in gastric cancer surgery: a multicenter cohort study and proposal for a new specific index (TOGS).Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026
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  9. Textbook outcome in gastrectomy: useful metric or moving target? A scoping review.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 4 institutions in 2 countries.

Jordan LevyDivision of General Surgery, Department of Surgery and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.ORCID 0000-0001-5333-5443
Vaibhav GuptaDivision of General Surgery, Department of Surgery and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
Elmira AmirazodiEvaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.
Catherine Allen-AyodaboEvaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.
Naheed JivrajDepartment of Anesthesia and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
Yunni JeongDivision of General Surgery, Department of Surgery and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
Laura E DavisEvaluative Clinical Sciences, Sunnybrook Research Institute, Toronto, Canada.
Alyson L MaharManitoba Centre for Health Policy and Department of Community Health Sciences, University of Manitoba, Toronto, Canada.
Charles De MestralDivision of Vascular Surgery, Department of Surgery and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada.
Olli SaarelaDalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Natalie CoburnDivision of General Surgery, Department of Surgery and Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Canada. Natalie.Coburn@sunnybrook.ca.
PRESTO Group
Sunnybrook Health Science Centre · CAUniversity of Toronto · CAManitoba Health · CASt. Michael's Hospital · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the association between gastric cancer surgery case-volume and Textbook Outcome, a new composite quality measurement.

backgroundTextbook Outcome included (a) negative resection margin, (b) greater than 15 lymph nodes sampled, (c) no severe complication, (d) no re-intervention, (e) no unplanned ICU admission, (f) length of stay of 21 days or less, (g) no 30-day readmission and (h) no 30-day mortality following surgery.

methodsAll patients undergoing gastrectomy for non-metastatic gastric adenocarcinoma registered in the Population Registry of Esophageal and Stomach Tumours of Ontario between 2004 and 2015 were included. We used multivariable generalized estimating equation (GEE) logistic regression modelling to estimate the association between gastrectomy volume (surgeon and hospital annual volumes) and Textbook Outcome. Volumes were considered as continuous variables and quintiles.

resultsTextbook Outcome was achieved in 378 of 1660 patients (22.8%). The quality metrics least often achieved were inadequate lymph node sampling and presence of severe complications, which occurred in 46.1% and 31.7% of patients, respectively. Accounting for covariates and clustering, neither surgeon volume nor hospital volume were significantly associated with Textbook Outcome. However, hospital volume was associated with adequate lymphadenectomy and fewer unplanned ICU admissions.

conclusionsHigher case volume can impact certain measures of quality of care but may not address all care structures necessary for ideal Textbook recovery. Future quality improvement strategies should consider using case-mix adjusted Textbook Outcome rates as a surgical quality metric.

Indexed as

AgedAged, 80 and overCanadaEsophageal NeoplasmsEsophagectomyFemaleFollow-Up StudiesGastrectomyHospitals, High-VolumeHumansLymph Node ExcisionMaleMiddle AgedRegistriesRetrospective StudiesStomach NeoplasmsGastrectomyGastric cancerSurgical qualityTextbookVolume

Identifiers

PMID31686260
OpenAlexW2987709845

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.