Textbook outcome in low rectal cancer patients undergoing laparoscopic or open surgery: 3-year results from the multicentric LASRE Trial.

IF 2.3 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

International Journal of Colorectal Disease Pub Date : 2025-08-13 DOI:10.1007/s00384-025-04976-w

Yanwu Sun, Zihan Tang, Weizhong Jiang, Xiaojie Wang, Ying Huang, Pan Chi

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引用次数: 0

Abstract

Purpose: The textbook outcome has emerged as a valuable metric for quality assessment in oncological surgery. However, its application and impact within randomized controlled trials involving patients with low rectal cancer remain underexplored. This study aimed to investigate the incidence and predictors of textbook outcome in patients with low rectal cancer undergoing laparoscopic or open resection.

Methods: This post-hoc analysis included patients from the prospective, multicentric LASRE trial with clinically staged I-III rectal cancer located within 5 cm of the dentate line, tumor diameter < 6 cm, and undergoing radical laparoscopic or open resection. A total of 914 patients were analyzed.

Results: A textbook outcome was achieved in 74.9% of patients, with a higher rate in the laparoscopic group (76.7%) than in the open group (71.2%, P = 0.07). Multivariate analysis identified independent predictors of textbook outcome failure, including BMI > 24 kg/m², surgical type (abdominoperineal resection), and operative time > 200 min. Achievement of a textbook outcome was associated with improved disease-free survival (DFS).

Conclusion: Achieving a textbook outcome is significantly associated with improved DFS in patients with low rectal cancer. These findings highlight the importance of optimizing perioperative and intraoperative care to enhance surgical outcomes, particularly within the context of randomized controlled trials.

Trial registration: ClinicalTrials.gov Identifier: https://clinicaltrials.gov/study/NCT01899547 .

查看原文本刊更多论文

接受腹腔镜或开放手术的低位直肠癌患者的教科书结局：来自多中心LASRE试验的3年结果

目的：教科书结果已成为肿瘤手术质量评估的一个有价值的指标。然而，其在低位直肠癌患者随机对照试验中的应用和影响仍未得到充分探讨。本研究旨在探讨低位直肠癌患者行腹腔镜或开放切除术的发生率和预后因素。方法：本回顾性分析纳入了前瞻性多中心LASRE试验中位于齿状线肿瘤直径5厘米内的临床分期I-III期直肠癌患者。结果：74.9%的患者达到了标准预后，腹腔镜组（76.7%）高于开放组（71.2%,P = 0.07）。多变量分析确定了教科书结局失败的独立预测因素，包括BMI > 24 kg/m2、手术类型（腹会阴切除）和手术时间>200min。达到教科书结局与改善无病生存（DFS）相关。结论：达到教科书结果与低位直肠癌患者DFS的改善显著相关。这些发现强调了优化围手术期和术中护理以提高手术效果的重要性，特别是在随机对照试验的背景下。试验注册：ClinicalTrials.gov标识符：https://clinicaltrials.gov/study/NCT01899547。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Colorectal Disease 医学-外科

CiteScore

4.90

自引率

3.60%

发文量

206

审稿时长

3-8 weeks

期刊介绍： The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.