Textbook Outcome Contributes to Long-term Prognosis in Elderly Patients with Esophageal Squamous Cell Carcinoma

Overview

Journal Ann Gastroenterol Surg

Date 2024 Sep 4

PMID 39229563

Authors

Chihiro Matsumoto

Masaaki Iwatsuki

Chishou Mitsuura

Atsushi Morito

Yuto Maeda

Tasuku Toihata

Keisuke Kosumi

Yoshifumi Baba

Naoya Yoshida

Hideo Baba

Affiliations

Soon will be listed here.

Abstract

Purpose: Textbook outcome (TO) is a composite quality measurement of outcomes for evaluating surgical procedures. We investigated whether TO can be used to predict outcomes after curative resection for esophageal squamous cell carcinoma (ESCC) in elderly patients.

Methods: We retrospectively analyzed 105 patients who underwent curative esophagectomy for ESCC from 2005 to 2020. In accordance with previous reports, TO consisted of 10 parameters. The patients were divided into two groups: those who achieved TO (TO) and those who failed to achieve TO (non-TO). We evaluated the association between TO and long-term survival.

Results: TO was achieved in 28 (26%) patients. The patients in the TO group were significantly older ( = 0.02). The parameter with the lowest achievement rate was "No hospital stay ≥21 days". The patients in non-TO group had significantly shorter overall survival than those in TO group ( = 0.03). Multivariable Cox regression analyses of overall survival revealed that lymph node metastasis (hazard ratio [HR], 3.42; 95% confidence interval [CI], 1.73-6.78; < 0.0002) and non-TO (HR, 2.37; 95% CI, 1.05-5.65; = 0.03) were significantly associated with poor overall survival.

Conclusion: TO can be used to predict outcomes after curative esophagectomy in elderly patients with ESCC.

References

Huang C, Wang M, Chen L, Wang H, Huang D, Shi J . The pretherapeutic systemic inflammation score is a prognostic predictor for elderly patients with oesophageal cancer: a case control study. BMC Cancer. 2023; 23(1):505. PMC: 10239588. DOI: 10.1186/s12885-023-10982-4. View

Kalff M, Vesseur I, Eshuis W, Heineman D, Daams F, van der Peet D . The Association of Textbook Outcome and Long-Term Survival After Esophagectomy for Esophageal Cancer. Ann Thorac Surg. 2020; 112(4):1134-1141. DOI: 10.1016/j.athoracsur.2020.09.035. View

van der Kaaij R, de Rooij M, van Coevorden F, Voncken F, Snaebjornsson P, Boot H . Using textbook outcome as a measure of quality of care in oesophagogastric cancer surgery. Br J Surg. 2018; 105(5):561-569. DOI: 10.1002/bjs.10729. View

Busweiler L, Schouwenburg M, van Berge Henegouwen M, Kolfschoten N, de Jong P, Rozema T . Textbook outcome as a composite measure in oesophagogastric cancer surgery. Br J Surg. 2017; 104(6):742-750. DOI: 10.1002/bjs.10486. View

Loyd C, Markland A, Zhang Y, Fowler M, Harper S, Wright N . Prevalence of Hospital-Associated Disability in Older Adults: A Meta-analysis. J Am Med Dir Assoc. 2019; 21(4):455-461.e5. PMC: 7469431. DOI: 10.1016/j.jamda.2019.09.015. View

Ten Berge M, Beck N, Steup W, Verhagen A, van Brakel T, Schreurs W . Textbook outcome as a composite outcome measure in non-small-cell lung cancer surgery. Eur J Cardiothorac Surg. 2020; 59(1):92-99. PMC: 7781522. DOI: 10.1093/ejcts/ezaa265. View

Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68(6):394-424. DOI: 10.3322/caac.21492. View

Xu S, Lin L, Chen C, Chen T, You C, Chen R . Textbook outcome after minimally invasive esophagectomy is an important prognostic indicator for predicting long-term oncological outcomes with locally advanced esophageal squamous cell carcinoma. Ann Transl Med. 2022; 10(4):161. PMC: 8908120. DOI: 10.21037/atm-22-506. View

Yoshida N, Nakamura K, Kuroda D, Baba Y, Miyamoto Y, Iwatsuki M . Preoperative Smoking Cessation is Integral to the Prevention of Postoperative Morbidities in Minimally Invasive Esophagectomy. World J Surg. 2018; 42(9):2902-2909. DOI: 10.1007/s00268-018-4572-3. View

10.

Bolger J, Al Azzawi M, Whooley J, Bolger E, Trench L, Allen J . Surgery by a minimally invasive approach is associated with improved textbook outcomes in oesophageal and gastric cancer. Eur J Surg Oncol. 2021; 47(9):2332-2339. DOI: 10.1016/j.ejso.2021.03.240. View

11.

Ma L, Li J, Shao L, Lin D, Xiang J . Prolonged postoperative length of stay is associated with poor overall survival after an esophagectomy for esophageal cancer. J Thorac Dis. 2015; 7(11):2018-23. PMC: 4669285. DOI: 10.3978/j.issn.2072-1439.2015.11.49. View

12.

. Japanese Classification of Esophageal Cancer, 11th Edition: part I. Esophagus. 2017; 14(1):1-36. PMC: 5222932. DOI: 10.1007/s10388-016-0551-7. View

13.

. Japanese Classification of Esophageal Cancer, 11th Edition: part II and III. Esophagus. 2017; 14(1):37-65. PMC: 5222925. DOI: 10.1007/s10388-016-0556-2. View

14.

Coory M, Scott I . Analysing low-risk patient populations allows better discrimination between high-performing and low-performing hospitals: a case study using inhospital mortality from acute myocardial infarction. Qual Saf Health Care. 2007; 16(5):324-8. PMC: 2464975. DOI: 10.1136/qshc.2006.018457. View

15.

Sachidananda S, Timsina L, Namburi N, Birdas T . Esophagectomy Complications Impact Long-term Survival: A National Cancer Database Analysis. Ann Surg. 2023; 277(3):437-441. DOI: 10.1097/SLA.0000000000005093. View

16.

Li R, He Y, Sun X, Wang N, Zhang M, Wei K . The long-term survival of esophageal cancer in elderly patients: A multi-center, retrospective study from China. Cancer Med. 2022; 12(4):4852-4863. PMC: 9972158. DOI: 10.1002/cam4.5307. View

17.

Kitagawa Y, Ishihara R, Ishikawa H, Ito Y, Oyama T, Oyama T . Esophageal cancer practice guidelines 2022 edited by the Japan Esophageal Society: part 2. Esophagus. 2023; 20(3):373-389. PMC: 10235142. DOI: 10.1007/s10388-023-00994-1. View

18.

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

19.

van Kooten R, Voeten D, Steyerberg E, Hartgrink H, van Berge Henegouwen M, van Hillegersberg R . Patient-Related Prognostic Factors for Anastomotic Leakage, Major Complications, and Short-Term Mortality Following Esophagectomy for Cancer: A Systematic Review and Meta-Analyses. Ann Surg Oncol. 2021; 29(2):1358-1373. PMC: 8724192. DOI: 10.1245/s10434-021-10734-3. View

20.

Kitagawa Y, Ishihara R, Ishikawa H, Ito Y, Oyama T, Oyama T . Esophageal cancer practice guidelines 2022 edited by the Japan esophageal society: part 1. Esophagus. 2023; 20(3):343-372. PMC: 10024303. DOI: 10.1007/s10388-023-00993-2. View