Textbook Outcome/Textbook Oncological Outcome for Pancreatic Cancer Treatment

Pancreatic surgery is an essential treatment for resectable pancreatic ductal adenocarcinoma (PDAC). However, perioperative morbidity and mortality are higher, and postoperative hospital stays are longer, than those for other gastrointestinal malignancies. Meanwhile, the quality of the perioperative surgical course affects both short- and long-term oncological outcomes in various malignancies.Recently, the concepts of textbook outcome (TO) and textbook oncological outcome (TOO) have been developed to evaluate the quality of perioperative surgical care. TO and TOO incorporate multiple perioperative elements and have been applied across various malignancies. In PDAC surgery, TO was defined in 2020 and consists of six short-term surgical outcomes: absence of postoperative pancreatic fistula, bile leak, post-pancreatectomy hemorrhage, severe complications (Clavien-Dindo grade ≥III), readmission, and in-hospital mortality.Previous studies have demonstrated that achieving TO or TOO is associated with improved survival after pancreatic surgery for PDAC. To optimize pancreatic surgery for resectable PDAC, it is essential to understand the characteristics and limitations of existing studies conducted prior to the widespread adoption of TO and TOO. This review summarizes the background, current status, and future perspectives of TO and TOO in pancreatic surgery.