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Related Experiment Video

Updated: Jan 13, 2026

Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
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Textbook Outcome After Gastrectomy Is Associated With Improved Survival: An Observational Study.

Ebbe Juul Kragbak1, Andreas Weise Mucha1, Pieter de Heer1

  • 1Department of Digestive Diseases, Transplantation and General Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.

The Journal of Surgical Research
|January 10, 2026
PubMed
Summary

Achieving a Textbook Outcome (TO) after gastric cancer surgery significantly improves patient survival. While Textbook Oncological Outcome (TOO) is less common, TO serves as a vital quality metric for surgical and oncological care.

Keywords:
GastrectomyGastric cancerQuality controlTextbook outcome

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Area of Science:

  • Oncology
  • Surgical Outcomes
  • Health Services Research

Background:

  • Gastric cancer treatment necessitates surgery and perioperative chemotherapy.
  • Textbook Outcome (TO) and Textbook Oncological Outcome (TOO) are emerging composite measures of ideal surgical and oncological care.
  • Evaluating TO and TOO rates after gastrectomy is crucial for assessing quality of care.

Purpose of the Study:

  • To determine the rates of Textbook Outcome (TO) and Textbook Oncological Outcome (TOO) following gastrectomy.
  • To investigate the association between achieving TO/TOO and long-term patient survival.

Main Methods:

  • A retrospective observational study included 141 patients undergoing gastrectomy.
  • TO criteria included radical resection, lymph node retrieval, absence of severe complications, and short hospital stay.
  • TOO included TO plus guideline-compliant chemotherapy; survival was analyzed using Kaplan-Meier and Cox regression.

Main Results:

  • Textbook Outcome (TO) was achieved in 56.7% of patients; Textbook Oncological Outcome (TOO) in 25.9%.
  • TO significantly correlated with improved overall survival (HR: 0.31) and recurrence-free survival (HR: 0.31).
  • Severe complications, reintervention, and readmission were primary reasons for not achieving TO.

Conclusions:

  • The study reports TO and TOO rates of 56.7% and 25.9%, respectively, indicating a high standard of care.
  • Textbook Outcome (TO) is a significant predictor of improved long-term survival.
  • TO is supported as a valuable quality metric in gastric cancer surgery.