Textbook Oncological Outcome in European GASTRODATA

Area of Science:

• Oncology
• Surgical Quality Assessment
• Gastric Cancer Treatment

Background:

• Textbook Outcome (TO) is a composite parameter for surgical quality, correlating with improved survival in gastric cancer.
• Textbook Oncological Outcome (TOO) was developed as a quality metric for optimal multimodal treatment in locally advanced gastric cancer.

Purpose of the Study:

• To evaluate the rates of Textbook Outcome (TO) and Textbook Oncological Outcome (TOO) in a European gastric cancer patient cohort.
• To identify factors influencing the achievement of TO and TOO in gastric cancer patients.

Main Methods:

• Analysis of 1700 patients from the GASTRODATA registry, assessing criteria for TO and TOO.
• Statistical analysis using logistic regression to determine factors impacting TO and TOO achievement.

Main Results:

• TO was achieved in 68.5% of patients; neoadjuvant chemotherapy and D2/D2+ lymphadenectomy positively impacted TO.
• Older age, advanced tumor stage (pT3/4), higher ASA score (3/4), and total gastrectomy negatively affected TO.
• TOO was achieved in 22.8% of patients; older age, advanced tumor stage, and higher ASA score negatively impacted TOO.

Conclusions:

• Adherence to perioperative chemotherapy guidelines for gastric cancer remains suboptimal despite surgical improvements.
• Future oncologic quality metrics should prioritize perioperative chemotherapy compliance and thorough lymphadenectomy.