ArticleBJS open2024
Textbook outcomes in the liver-first approach for colorectal liver metastases: prospective multicentre analysis.
Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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Who cites it
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Liver-first approach to the treatment of patients with synchronous colorectal liver metastases: a systematic review and meta-analysis.Einstein (Sao Paulo, Brazil) · 2024Pooled it
- Does calculating the textbook outcome based on its negative predictors enhance the transparency of intrahepatic cholangiocarcinoma surgery assessment?Annals of hepato-biliary-pancreatic surgery · 2026Article
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11 authors.
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Abstract
backgroundTextbook outcome is a valuable tool for assessing surgical outcomes. The aim of this study was to analyse textbook-outcome rates in the prospective Spanish National Registry of the Liver-First Approach (RENACI Project) and the factors influencing textbook-outcome achievement. Additionally, a model for assessing a procedure-specific textbook outcome for the liver-first approach was proposed.
methodsA retrospective analysis of a prospective and multicentre database that included consecutive patients with colorectal cancers and synchronous liver metastases who underwent a liver-first approach between June 2019 and August 2020 was performed. Two types of textbook outcome were measured: classic textbook outcome and liver-first-approach-specific textbook outcome (which included negative margins, no perioperative transfusion, no postoperative major surgical complications, no prolonged length of hospital stay, no readmissions, no mortality, and full treatment completion). The primary endpoint was textbook-outcome rate for a liver-first approach at 90 days.
resultsA total of 149 patients were included in the analysis. Classic and liver-first-approach-specific textbook-outcome rates were 71.8 per cent (107 patients) and 46 per cent (69 patients) respectively. Factors significantly associated with liver-first-approach-specific textbook-outcome achievement in the multivariable analysis were the number of metastases (OR 0.82 (95 per cent c.i. 0.73 to 0.92); P = 0.001) and intraoperative blood loss (OR 0.99 (95 per cent c.i. 0.99 to 1.00); P = 0.007). Prolonged length of hospital stay (33 patients, 41 per cent), positive margins (31 patients, 39 per cent), perioperative transfusion (27 patients, 34 per cent), and no full treatment completion (18 patients, 23 per cent) were the items that most frequently prevented liver-first-approach-specific textbook-outcome achievement.
conclusionLiver-first-approach-specific textbook outcome is a promising tool for measuring the quality of care when using the liver-first approach for synchronous colorectal liver metastases.
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