Association between textbook outcomes of liver surgery (TOLS) and overall survival in gallbladder cancer patients treated with curative-intent resection: A multicenter study.
Zi-Mu Li, Hui-Ying Ouyang, Yi Gong, Hai-Su Dai, Jie Bai, Yan Jiang, Xian-Yu Yin, Zhi-Yu Chen, Shu-Guo Zheng, Yun-Feng Li, Chao Yu, Fan Huang, Zhao-Ping Wu, Jin-Xue Zhou, Da-Long Yin, Rui Ding, Wei Guo, Yi Zhu, Wei Chen, Ke-Can Lin, Ping Yue, Yao Cheng, Dong Zhang, Yan-Qi Zhang, Zhi-Peng Liu, Tao Qin
{"title":"Association between textbook outcomes of liver surgery (TOLS) and overall survival in gallbladder cancer patients treated with curative-intent resection: A multicenter study.","authors":"Zi-Mu Li, Hui-Ying Ouyang, Yi Gong, Hai-Su Dai, Jie Bai, Yan Jiang, Xian-Yu Yin, Zhi-Yu Chen, Shu-Guo Zheng, Yun-Feng Li, Chao Yu, Fan Huang, Zhao-Ping Wu, Jin-Xue Zhou, Da-Long Yin, Rui Ding, Wei Guo, Yi Zhu, Wei Chen, Ke-Can Lin, Ping Yue, Yao Cheng, Dong Zhang, Yan-Qi Zhang, Zhi-Peng Liu, Tao Qin","doi":"10.1159/000548351","DOIUrl":null,"url":null,"abstract":"<p><p>Background This study investigated the relationship between textbook outcomes of liver surgery (TOLS) and overall survival (OS) in patients who underwent curative-intent resection of GBC. Method Patients with GBC who underwent curative-intent resection between 2014 and 2021 were selected from 16 hospitals. Patients were divided into either the TOLS group or the non-TOLS group according to whether TOLS were observed. Patients who died within 90 days of surgery were excluded prior to the survival analysis. Log-rank test was used to compare the difference in the OS rate between TOLS and non-TOLS groups. Univariate and multivariate analyses were performed using Cox regression analysis to identify factors independently associated with OS. Results A total of 913 patients were selected, 565 (61.9%) exhibited TOLS. The 5-year OS rate in the TOLS group was significantly higher than that in the non-TOLS group (45.4% vs. 21.9%; P<0.001). Multivariate Cox regression analysis confirmed TOLS, TB level> 54 µmol/ml, CEA level> 5 µg/ml, CA19-9 level> 37 U/L, poor differentiation, stages T2 and T3/4 according to the 8th edition AJCC T staging manual, N1 and N2 according to the 8th edition AJCC N staging manual, and adjuvant chemotherapy as independent risk factors that affect OS after curative-intent resection of GBC. Conclusion Among patients who undergo curative-intent resection of GBC, approximately 61.9% experience TOLS. TOLS are not only the optimal short-term outcome but also associated with long-term survival.</p>","PeriodicalId":11241,"journal":{"name":"Digestive Surgery","volume":" ","pages":"1-21"},"PeriodicalIF":1.2000,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Digestive Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000548351","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background This study investigated the relationship between textbook outcomes of liver surgery (TOLS) and overall survival (OS) in patients who underwent curative-intent resection of GBC. Method Patients with GBC who underwent curative-intent resection between 2014 and 2021 were selected from 16 hospitals. Patients were divided into either the TOLS group or the non-TOLS group according to whether TOLS were observed. Patients who died within 90 days of surgery were excluded prior to the survival analysis. Log-rank test was used to compare the difference in the OS rate between TOLS and non-TOLS groups. Univariate and multivariate analyses were performed using Cox regression analysis to identify factors independently associated with OS. Results A total of 913 patients were selected, 565 (61.9%) exhibited TOLS. The 5-year OS rate in the TOLS group was significantly higher than that in the non-TOLS group (45.4% vs. 21.9%; P<0.001). Multivariate Cox regression analysis confirmed TOLS, TB level> 54 µmol/ml, CEA level> 5 µg/ml, CA19-9 level> 37 U/L, poor differentiation, stages T2 and T3/4 according to the 8th edition AJCC T staging manual, N1 and N2 according to the 8th edition AJCC N staging manual, and adjuvant chemotherapy as independent risk factors that affect OS after curative-intent resection of GBC. Conclusion Among patients who undergo curative-intent resection of GBC, approximately 61.9% experience TOLS. TOLS are not only the optimal short-term outcome but also associated with long-term survival.
期刊介绍:
''Digestive Surgery'' presents a comprehensive overview in the field of gastrointestinal surgery. Interdisciplinary in scope, the journal keeps the specialist aware of advances in all fields that contribute to improvements in the diagnosis and treatment of gastrointestinal disease. Particular emphasis is given to articles that evaluate not only recent clinical developments, especially clinical trials and technical innovations such as new endoscopic and laparoscopic procedures, but also relevant translational research. Each contribution is carefully aligned with the need of the digestive surgeon. Thus, the journal is an important component of the continuing medical education of surgeons who want their practice to benefit from a familiarity with new knowledge in all its dimensions.