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Evaluation of optimum classification measures used to define textbook outcome among patients undergoing curative-intent resection of gastric cancer

dc.contributor.authorL Bobrzynski
dc.contributor.authorK Sędłak
dc.contributor.authorK Rawicz-Pruszyński
dc.contributor.authorP Kolodziejczyk
dc.contributor.authorA Szczepanik
dc.contributor.authorW Polkowski
dc.contributor.authorP Richter
dc.contributor.authorM Sierzega
dc.contributor.otherFirst Department of Surgery, Jagiellonian University Medical College
dc.contributor.otherDepartment of Surgical Oncology, Medical University of Lublin
dc.contributor.otherDepartment of Surgical Oncology, Medical University of Lublin
dc.contributor.otherFirst Department of Surgery, Jagiellonian University Medical College
dc.contributor.otherFirst Department of Surgery, Jagiellonian University Medical College
dc.contributor.otherDepartment of Surgical Oncology, Medical University of Lublin
dc.contributor.otherFirst Department of Surgery, Jagiellonian University Medical College
dc.contributor.otherFirst Department of Surgery, Jagiellonian University Medical College
dc.date.accessioned2023-12-10T12:21:49Z
dc.date.accessioned2025-10-08T08:06:54Z
dc.date.available2025-10-08T08:06:54Z
dc.date.issued2023-12
dc.identifier.urihttp://digilib.fisipol.ugm.ac.id/repo/handle/15717717/35604
dc.description.abstractAbstract Background Textbook outcome (TO) is a composite measure reflecting various aspects of services provided to patients with solid malignancies. We sought to evaluate the importance of various TO components previously proposed for gastric cancer. Methods Prospectively maintained electronic databases of 1,743 patients treated in two academic surgical centres were reviewed. Six candidate definitions of TO were evaluated based on their ability to accurately predict patients’ prognosis by Cox proportional hazards modelling. Results TO definition combining 10 measures corresponding to complete tumour resection with an uneventful postoperative course showed the best goodness of fit by achieving the lowest values of Akaike (AIC) and Bayesian (BIC) information criteria and the best predictive performance based on the highest value of c-index. The overall median survival was significantly longer for patients with than without textbook outcome (69.0 vs 20.1 months, P < 0.001). TO maintained its prognostic value in a multivariate model controlling for age, sex, comorbidities, treatment, and tumour related variables and was associated with a 39% lower risk of death (HR 0.61, 95%CI 0.51 – 0.73, P < 0.001). Nine variables identified as predictors of TO were used to develop a nomogram showing very good correlation between the predicted and actual probability of achieving TO. The AUC of ROC obtained from the nomogram was 0.752 (95% CI 0.727 to 0.781). Conclusions A uniform definition of textbook outcome provides clinically relevant prognostic information and could be used in quality improvement programs for gastric cancer patients.
dc.language.isoEN
dc.publisherBMC
dc.subject.lccNeoplasms. Tumors. Oncology. Including cancer and carcinogens
dc.titleEvaluation of optimum classification measures used to define textbook outcome among patients undergoing curative-intent resection of gastric cancer
dc.typeArticle
dc.description.keywordsGastric cancer
dc.description.keywordsTextbook outcome
dc.description.keywordsPrognosis
dc.description.pages1-10
dc.description.doi10.1186/s12885-023-11695-4
dc.title.journalBMC Cancer
dc.identifier.e-issn1471-2407
dc.identifier.oai6a3e28a6ed774bac8c071747a691329a
dc.journal.infoVolume 23, Issue 1


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