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Tytuł:
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Textbook Outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma: A large multicenter sample analysis.
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Autorzy:
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Chen Q; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou 350004, China.; Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou 350004, China.
Ning Z; Department of Gastrointestinal Surgery, West District of the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230001, China.
Liu Z; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Zhou Y; Department of Gastrointestinal Surgery, Affiliated Hospital of Qingdao University, Qingdao 266000, China.
He Q; Department of Gastrointestinal Surgery, the First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China.
Tian Y; Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Hao H; Department of General Surgery, Huashan Hospital, Fudan University, Shanghai 200040, China.
Lin W; Department of Gastrointestinal Surgery and Gastrointestinal Surgery Research Institute, the Affiliated Hospital of Putian University, Putian 351106, China.
Jiang L; Department of Gastrointestinal Surgery, Yantai Yuhuangding Hospital, Yantai 264099, China.
Zhao G; Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiaotong University, Shanghai 200127, China.
Li P; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou 350004, China.; Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou 350004, China.
Zheng C; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou 350004, China.; Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou 350004, China.
Huang C; Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, China.; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou 350004, China.; Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou 350004, China.
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Corporate Authors:
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Study Group for Gastric Neuroendocrine Tumors
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Źródło:
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Chinese journal of cancer research = Chung-kuo yen cheng yen chiu [Chin J Cancer Res] 2021 Aug 31; Vol. 33 (4), pp. 433-446.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Original Publication: Beijing, China : Beijing Institute for Cancer Research, [1988-
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References:
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Contributed Indexing:
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Keywords: Textbook Outcome; gastric neuroendocrine carcinoma; prognosis; risk factor; surgical quality
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Entry Date(s):
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Date Created: 20210929 Latest Revision: 20230921
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Update Code:
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20240105
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PubMed Central ID:
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PMC8435827
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DOI:
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10.21147/j.issn.1000-9604.2021.04.01
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PMID:
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34584369
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Objective: Quality assurance is crucial for oncological surgical treatment assessment. For rare diseases, single-quality indicators are not enough. We aim to develop a comprehensive and reproducible measurement, called the "Textbook Outcome" (TO), to assess the quality of surgical treatment and prognosis of gastric neuroendocrine carcinoma (G-NEC) patients.
Methods: Data from patients with primary diagnosed G-NEC included in 24 high-volume Chinese hospitals from October 2005 to September 2018 were analyzed. TO included receiving a curative resection, ≥15 lymph nodes examined, no severe postoperative complications, hospital stay ≤21 d, and no hospital readmission ≤30 d after discharge. Hospital variation in TO was analyzed using a case mix-adjusted funnel plot. Prognostic factors of survival and risk factors for non-Textbook Outcome (non-TO) were analyzed using Cox and logistic models, respectively.
Results: TO was achieved in 56.6% of 860 G-NEC patients. TO patients had better overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) than non-TO patients (P<0.05). Moreover, TO patients accounted for 60.3% of patients without recurrence. Multivariate Cox analysis revealed non-TO as an independent risk factor for OS, DFS, and RFS of G-NEC patients (P<0.05). Increasing TO rates were associated with improved OS for G-NEC patients, but not hospital volume. Multivariate logistic regression revealed that non-lower tumors, open surgery, and >200 mL blood loss were independent risk factors for non-TO patients (P<0.05).
Conclusions: TO is strongly associated with multicenter surgical quality and prognosis for G-NEC patients. Factors predicting non-TO are identified, which may help guide strategies to optimize G-NEC outcomes.
Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
(Copyright ©2021Chinese Journal of Cancer Research. All rights reserved.)
