Textbook oncologic outcome is associated with increased overall survival after esophagectomy

Surgery
Sujay KulshresthaMarshall S Baker

Abstract

Assessment of quality in oncologic operations traditionally involves use of discrete metrics reported individually. Such metrics have limited value to payers and patients making broad comparisons of clinical programs. We define a composite textbook oncologic outcome for esophagectomy. The National Cancer Database was queried to identify patients presenting with clinically resectable esophageal cancer between 2004 and 2015. Textbook oncologic outcome was defined as stage-appropriate use of neoadjuvant chemoradiation followed by margin negative esophagectomy with formal lymph node assessment and having no prolonged hospitalization, readmission, or 30-day mortality. Fourteen thousand nine hundred and sixty-nine patients underwent esophagectomy. Of those, 5,561 (37.2%) had textbook oncologic outcome. The overall survival of patients having textbook oncologic outcome was significantly longer than those who did not (52.1 (95% confidence interval [49.0-58.8]) vs 29.1 months (95% confidence interval [29.1-32.3]). On multivariable modeling adjusted for age, comorbid conditions, demographics, treatment characteristics, and esophagectomy volume, volume (odds ratio 1.38, 95% confidence interval [1.16-1.65]) and minimally invasive approach ...Continue Reading

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Citations

Jun 15, 2021·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·A K WarpsUNKNOWN Dutch ColoRectal Audit group
Aug 16, 2021·Annals of Surgical Oncology·Christopher T AquinaAslam Ejaz
Aug 20, 2021·Seminars in Thoracic and Cardiovascular Surgery·Sujay KulshresthaUNKNOWN Loyola Thoracic Outcomes Group

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