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• W3107966837 abstract "Quality assurance is crucial for oncological surgical treatment assessment. For rare diseases, single-quality indicators are not enough. To develop a comprehensive and reproducible measurement, called the Textbook Outcome” (TO), to assess the quality of surgical and prognosis of gastric neuroendocrine carcinoma (G-NEC) patients. Data from patients with primary diagnosed gastric neuroendocrine neoplasms (G-NEN) included in the Study Group for Gastric Neuroendocrine Tumors (involving 24 high-volume Chinese hospitals, October 2005-September 2018) were analyzed. After applying the exclusion criteria, 860 G-NEC patients were included in this study. TO included receiving a curative resection, ≥15 lymph nodes (LNs) examined, no severe postoperative complication, hospital stay ≤21 days, and no hospital readmission ≤30 days after discharge. A Sankey plot displayed changes between TO and long-term survival. Hospital variation in TO was analyzed using a case mix-adjusted funnel plot. Prognostic factors for survival and risk factors for non-TO were analyzed using Cox and logistic regression analyses, respectively. TO was achieved in 56.6% of G-NEC patients. TO patients had better overall (OS), disease-free (DFS), and recurrence-free (RFS) survivals than non-TO patients (P <0.05). Sankey plot showed that the prognostic outcome of most TO patients flowed to alive (62.1%). 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). 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." @default.
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• W3107966837 date "2020-11-01" @default.
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• W3107966837 title "183P Textbook outcome as a measure of surgical quality assessment and prognosis in gastric neuroendocrine carcinoma: A large multicenter sample analysis" @default.
• W3107966837 doi "https://doi.org/10.1016/j.annonc.2020.10.204" @default.
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