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":"一项多中心研究:胆囊癌患者肝手术预后(TOLS)与治疗目的切除的总生存率之间的关系","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":"{\"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}","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
摘要
本研究调查了肝外科手术结局(TOLS)与接受治疗目的肝细胞癌切除术患者总生存率(OS)之间的关系。方法选择2014 - 2021年在16家医院行有意治愈切除的GBC患者。根据是否观察到tools,将患者分为tools组和非tools组。手术90天内死亡的患者在生存分析之前被排除在外。采用Log-rank检验比较tools组与非tools组的OS率差异。采用Cox回归分析进行单因素和多因素分析,以确定与OS独立相关的因素。结果共入选913例患者,565例(61.9%)出现TOLS。TOLS组5年OS率显著高于非TOLS组(45.4% vs. 21.9%); P 54µmol/ml, CEA水平> 5µg/ml, CA19-9水平> 37 U/L,分化差,第8版AJCC T分期手册T2和T3/4期,第8版AJCC N分期手册N1和N2期,辅助化疗是影响GBC术后OS的独立危险因素。结论在接受治疗目的GBC切除术的患者中,约61.9%的患者经历了TOLS。TOLS不仅是最佳的短期结果,而且与长期生存有关。
Association between textbook outcomes of liver surgery (TOLS) and overall survival in gallbladder cancer patients treated with curative-intent resection: A multicenter study.
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.