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Impact of Textbook Oncologic Outcome on long term survival after resection for pancreatic adenocarcinoma

  • 0Department of General and Oncological Surgery, Mauriziano Hospital, Turin, Italy.
Pancreatology : Official Journal of the International Association of Pancreatology (iap) ... [et Al.] +

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September 18, 2025

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September 18, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Textbook Oncologic Outcome (TOO) in pancreatic cancer surgery is achievable in one-third of patients. However, achieving TOO did not improve long-term survival or disease-free survival in this study.

Area Of Science

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background

  • Textbook Oncologic Outcome (TOO) is a proposed metric for optimal oncologic care after pancreatic ductal adenocarcinoma (PDAC) resection.
  • Evaluating the impact of achieving TOO on long-term results after PDAC resection is crucial.

Purpose Of The Study

  • To assess the impact of achieving Textbook Oncologic Outcome (TOO) on long-term outcomes after pancreatic ductal adenocarcinoma (PDAC) resection.
  • To identify factors associated with achieving TOO and their correlation with overall survival (OS) and disease-free survival (DFS).

Main Methods

  • Retrospective analysis of data from a prospectively maintained database of 268 patients undergoing PDAC resection.
  • TOO defined by margin-negative resection, compliant lymph node evaluation, length of stay (LOS) ≤50th percentile, no 30-day readmission/mortality, and adjuvant chemotherapy.
  • Statistical evaluation of factors associated with TOO achievement and their impact on OS and DFS.

Main Results

  • TOO was achieved in 30.2% of patients; key components included R0 margin (76.5%) and adjuvant chemotherapy (68.3%).
  • No significant difference in median OS (24.5 vs. 22.2 months) or DFS (17.9 vs. 16.9 months) was observed between patients who achieved TOO and those who did not.
  • Independent predictors of OS were lymph node positivity and adjuvant chemotherapy.

Conclusions

  • Textbook Oncologic Outcome (TOO) can be achieved in a significant proportion of PDAC resections but did not correlate with improved long-term survival in this cohort.
  • TOO serves as a valuable surgical quality metric but not as a prognostic indicator for long-term outcomes in PDAC patients.

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