Developing a modified textbook outcome for elderly patients with gastric cancer: a multi-center study

Area of Science:

• Oncology
• Surgical Oncology
• Geriatric Medicine

Background:

• Textbook Outcome (TO) is a key prognostic indicator for gastric cancer (GC).
• Elderly GC patients require tailored prognostic assessment.
• Existing TO may not fully capture prognostic factors in elderly GC.

Purpose of the Study:

• To develop and validate a modified TO (mTO) for elderly GC patients.
• To identify independent prognostic factors for Overall Survival (OS) in this demographic.
• To create a predictive model for OS using the mTO.

Main Methods:

• Retrospective analysis of 1389 elderly GC patients (training cohort) and 185 (validation cohort).
• Cox regression analysis to identify independent prognostic factors for OS.
• Development of a nomogram incorporating mTO and other significant factors.

Main Results:

• Surgical approach was identified as an independent prognostic factor for OS, distinct from traditional TO.
• The modified TO (mTO) was developed by including surgical approach.
• The mTO-based nomogram demonstrated high accuracy in predicting 1-, 3-, and 5-year OS in both cohorts.

Conclusions:

• The mTO is strongly associated with prognosis in elderly GC patients.
• The predictive model incorporating mTO shows excellent performance for elderly GC.
• Enhanced focus on mTO can improve surgical quality and patient outcomes.