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Textbook outcome, chemotherapy compliance, and prognosis after radical gastrectomy for gastric cancer: A large sample analysis

  • Author Footnotes
    1 Jun-Yu Chen and Guang-Tan Lin contributed equally to this work and should be considered co-first authors.
    Jun-Yu Chen
    Footnotes
    1 Jun-Yu Chen and Guang-Tan Lin contributed equally to this work and should be considered co-first authors.
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Author Footnotes
    1 Jun-Yu Chen and Guang-Tan Lin contributed equally to this work and should be considered co-first authors.
    Guang-Tan Lin
    Footnotes
    1 Jun-Yu Chen and Guang-Tan Lin contributed equally to this work and should be considered co-first authors.
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Qi-Yue Chen
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Qing Zhong
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Zhi-Yu Liu
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Si-Jin Que
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Jia-Bin Wang
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Jian-Xian Lin
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Jun Lu
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Long-Long Cao
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Mi Lin
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Ru-Hong Tu
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Ze-Ning Huang
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Ju-Li Lin
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Hua-Long Zheng
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Jian-Wei Xie
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Ping Li
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Chang-Ming Huang
    Correspondence
    Corresponding author. Department of Gastric Surgery, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Chao-Hui Zheng
    Correspondence
    Corresponding author. Department of Gastric Surgery, Fujian Medical University Union Hospital, No.29 Xinquan Road, Fuzhou, 350001, Fujian Province, China.
    Affiliations
    Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China

    Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China

    Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China
    Search for articles by this author
  • Author Footnotes
    1 Jun-Yu Chen and Guang-Tan Lin contributed equally to this work and should be considered co-first authors.

      Abstract

      Background

      This study aims to analyze the effect of textbook outcome (TO) on the long-term prognosis and adjuvant chemotherapy (AC) compliance of patients with gastric cancer (GC) in a single institute.

      Materials and methods

      Consecutive patients who underwent radical gastrectomy with pathological stage I-III at Union Hospital of Fujian Medical University from January 2010 to June 2017 were included. TO was defined as receiving a complete-potentially curative status, ≥15 lymph nodes examined, hospital stay ≤21 days, and freedom from intraoperative and postoperative complications, re-intervention in 30 days, 30-day readmission to the hospital or intensive care unit, and 30-day postoperative mortality.

      Results

      Totally 3993 patients were included, of which 3361 (84.2%) patients achieved TO. The overall, disease-specific, and recurrence-free survival of patients achieving TO were significantly better than those of patients without achieving TO (all P < 0.05). The total number of AC cycles was greater and the interval from surgery to first AC was shorter in the TO group compared with the Non-TO group. Age >65 years old, open surgery, pT3-4 stage, and total radical gastrectomy (TG) were identified as related high-risk factors for failure to achieve TO. Laparoscopic surgery facilitated TO achievement in high-risk groups.

      Conclusion

      TO is a reliable indicator of favorable prognosis of patients with GC and contributes to postoperative chemotherapy compliance. Age ≤65 years old, non-TG, pT1-2 stage, and laparoscopic surgery may promote the achievement of TO.

      Keywords

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