ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2022
Trends in Textbook Outcomes over Time: Are Optimal Outcomes Following Complex Gastrointestinal Surgery for Cancer Increasing?
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 31 citations in OpenAlex.
- The "Textbook Outcome" Isn't Textbook: Significant Variation in "Textbook Outcome" Definitions following a Systematic Review of the Surgical Oncology Literature.Annals of surgical oncology · 2026Pooled it
- Textbook Outcomes in Liver Surgery: a Systematic Review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Pooled it
- Pooled it
- Beyond Mortality: Textbook Outcome as a Novel Quality Metric in Cardiothoracic Surgical Care.Journal of clinical medicine · 2025Review
- Impact of Contemporary Redlining on Healthcare Disparities Among Patients with Gastrointestinal Cancer: A Mediation Analysis.Annals of surgical oncology · 2025Article
- Evolution of Liver Resection for Hepatocellular Carcinoma: Change Point Analysis of Textbook Outcome over Twenty Years.Medicina (Kaunas, Lithuania) · 2024Article
- The Association of Established Primary Care with Postoperative Outcomes Among Medicare Patients with Digestive Tract Cancer.Annals of surgical oncology · 2024Article
- The Role of Delirium on Short- and Long-Term Postoperative Outcomes Following Major Gastrointestinal Surgery for Cancer.Annals of surgical oncology · 2024Article
- The Value of Textbook Outcome in Benchmarking Pancreatoduodenectomy for Nonfunctioning Pancreatic Neuroendocrine Tumors.Annals of surgical oncology · 2024Article
- Textbook oncologic outcomes are associated with increased overall survival in patients with pancreatic head cancer after undergoing laparoscopic pancreaticoduodenectomy.World journal of surgical oncology · 2024Article
- Poor Access to Mental Healthcare is Associated with Worse Postoperative Outcomes Among Patients with Gastrointestinal Cancer.Annals of surgical oncology · 2024Article
- Evaluation of optimum classification measures used to define textbook outcome among patients undergoing curative-intent resection of gastric cancer.BMC cancer · 2023Article
- Challenge for the future: assessing the quality of abdominal surgery using composite quality measures.BJS open · 2023Article
- Analysis of textbook outcomes for ampullary carcinoma patients following pancreaticoduodenectomy.World journal of gastrointestinal surgery · 2023Article
- The value of analyzing textbook outcomes after laparoscopic hepatectomy-a narrative review.Translational cancer research · 2023Review
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe use of composite measures like "textbook outcome" (TO) may provide a more accurate measure of surgical quality. We sought to determine if TO has improved over time and to characterize the association of achieving a TO with trends in survival among patients undergoing complex gastrointestinal surgery for cancer.
methodsMedicare beneficiaries who underwent pancreas, liver, or colon resection for a cancer diagnosis between 2004 and 2016 were identified using the SEER-Medicare database. Rates of TO (no complication, extended length of stay, 90-day readmission, or 90-day mortality) were assessed over time.
resultsAmong 94,329 patients, 6765 (7.2%), 1985 (2.1%), and 85,579 (90.7%) patients underwent resection for primary pancreatic, hepatic, or colon cancer, respectively. In total, 53,464 (56.7%) patients achieved a TO; achievement of TO varied by procedure (pancreatectomy: 48.1% vs. hepatectomy: 55.2% vs. colectomy: 57.4%, p < 0.001). The proportion of patients achieving a textbook outcome increased over time for all patients (2004-2007, 53.3% vs. 2008-2011, 56.5% vs. 2012-2016, 60.1%) (5-year increase: OR 1.16 95%CI 1.13-1.18) (p < 0.001). Survival at 1-year following pancreatic, liver, or colon resection for cancer had improved over time among both patients who did and did not achieve a postoperative TO. TO was independently associated with a marked reduction in hazard of death (HR 0.44, 95%CI 0.43-0.45). The association of TO and survival was consistent among patients stratified by procedure.
conclusionLess than two-thirds of patients undergoing complex gastrointestinal surgery for a malignant indication achieved a TO. The likelihood of achieving a TO increased over time and was associated with improved survival.
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