Developing a modified textbook outcome for elderly patients with gastric cancer: a multi-center study
Objective Textbook outcome (TO) is widely recognized as a comprehensive prognostic indication for patients with gastric cancer (GC). This study aims to develop a modified TO (mTO) for elderly patients with GC. Methods Data from the elderly patients (aged ≥ 65 years) in two Chinese tertiary referral...
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| creator | Zhong, Qing Zheng, Zi-Fang Wu, Dong Shang-Guan, Zhi-Xin Liu, Zhi-Yu Zheng, Lin-Yong Lin, Jian-Xian Chen, Qi-Yue Wang, Jia-Bin Xie, Jian-Wei Lin, Mi Lin, Wei Zheng, Chao-Hui Huang, Chang-Ming Li, Ping |
| description | Objective
Textbook outcome (TO) is widely recognized as a comprehensive prognostic indication for patients with gastric cancer (GC). This study aims to develop a modified TO (mTO) for elderly patients with GC.
Methods
Data from the elderly patients (aged ≥ 65 years) in two Chinese tertiary referral hospitals were analyzed. 1389 patients from Fujian Medical University Union Hospital were assigned as the training cohort and 185 patients from Affiliated Hospital of Putian University as the validation cohort. Nomogram was developed by the independent prognostic factors of Overall Survival (OS) based on Cox regression.
Results
In the training cohort, laparoscopic surgery was significantly correlated with higher TO rate (
P
|
| doi_str_mv | 10.1007/s00464-024-11116-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3095174401</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3113885697</sourcerecordid><originalsourceid>FETCH-LOGICAL-c256t-95f1c9f9fb1598c26b6fdcc0bbc2fe469decba87c100c792fdc56212b624d9183</originalsourceid><addsrcrecordid>eNp9kctO3TAQhq2KqhygL9AFssSmGxff4sTsEAVaCambsrYSZ3xqSOKD7VDy9jU9XCQWzGYW880_lx-hL4x-Y5TWx4lSqSShXBJWQpHlA1oxKTjhnDU7aEW1oITXWu6ivZRuaOE1qz6hXaGZklLUKwTf4R6GsPHTGrd4DL13Hnqc4SF3IdziMGcbRsAuRAxDD3FY8KbNHqac8F-f_-B1m3L0Ftt2shBPHlXmIXtiCwIRpzz3ywH66NohweenvI-uL85_n_0gV78uf56dXhHLK5WJrhyz2mnXsUo3lqtOud5a2nWWO5BK92C7tqltOd_WmpdipTjjneKy16wR--jrVncTw90MKZvRJwvD0E4Q5mQE1RWrpaSsoEdv0Jswx6lsZwRjomkqpetC8S1lY0gpgjOb6Mc2LoZR82iC2ZpgignmvwlmKU2HT9JzN0L_0vL89QKILZBKaVpDfJ39juw_0NmT3Q</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3113885697</pqid></control><display><type>article</type><title>Developing a modified textbook outcome for elderly patients with gastric cancer: a multi-center study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Zhong, Qing ; Zheng, Zi-Fang ; Wu, Dong ; Shang-Guan, Zhi-Xin ; Liu, Zhi-Yu ; Zheng, Lin-Yong ; Lin, Jian-Xian ; Chen, Qi-Yue ; Wang, Jia-Bin ; Xie, Jian-Wei ; Lin, Mi ; Lin, Wei ; Zheng, Chao-Hui ; Huang, Chang-Ming ; Li, Ping</creator><creatorcontrib>Zhong, Qing ; Zheng, Zi-Fang ; Wu, Dong ; Shang-Guan, Zhi-Xin ; Liu, Zhi-Yu ; Zheng, Lin-Yong ; Lin, Jian-Xian ; Chen, Qi-Yue ; Wang, Jia-Bin ; Xie, Jian-Wei ; Lin, Mi ; Lin, Wei ; Zheng, Chao-Hui ; Huang, Chang-Ming ; Li, Ping</creatorcontrib><description>Objective
Textbook outcome (TO) is widely recognized as a comprehensive prognostic indication for patients with gastric cancer (GC). This study aims to develop a modified TO (mTO) for elderly patients with GC.
Methods
Data from the elderly patients (aged ≥ 65 years) in two Chinese tertiary referral hospitals were analyzed. 1389 patients from Fujian Medical University Union Hospital were assigned as the training cohort and 185 patients from Affiliated Hospital of Putian University as the validation cohort. Nomogram was developed by the independent prognostic factors of Overall Survival (OS) based on Cox regression.
Results
In the training cohort, laparoscopic surgery was significantly correlated with higher TO rate (
P
< 0.05). Cox regression analysis revealed that surgical approach was also an independent factor of OS (
P
< 0.001), distinct from the traditional TO. In light of these findings, TO parameters were enhanced by the inclusion of surgical approach, rendering a modified TO (mTO). Further analysis showed that mTO, tumor size, pTNM staging, and adjuvant chemotherapy were independent prognostic factors associated with OS (all
P
< 0.05). Additionally, the nomogram incorporating these four indicators accurately predicted 1-, 3-, and 5-year OS in the training cohort, with AUC values of 0.793, 0.814, and 0.807, respectively, and exhibited outstanding predictive performance within the validation cohort.
Conclusion
mTO holds a robust association with the prognosis of elderly patients with GC, meriting intensified attention in efforts aimed at enhancing surgical quality. Furthermore, the predictive model incorporating mTO demonstrates excellent predictive performance for elderly patients with GC.</description><identifier>ISSN: 0930-2794</identifier><identifier>ISSN: 1432-2218</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-024-11116-y</identifier><identifier>PMID: 39164437</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Aged ; Aged, 80 and over ; Chemotherapy ; Clinical outcomes ; Endoscopy ; Female ; Gastrectomy - methods ; Gastric cancer ; Gastroenterology ; Gastrointestinal surgery ; Gynecology ; Hepatology ; Humans ; Laparoscopy ; Laparoscopy - methods ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Neoplasm Staging ; Nomograms ; Proctology ; Prognosis ; Retrospective Studies ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Surgery ; Survival Rate</subject><ispartof>Surgical endoscopy, 2024-10, Vol.38 (10), p.5869-5880</ispartof><rights>The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c256t-95f1c9f9fb1598c26b6fdcc0bbc2fe469decba87c100c792fdc56212b624d9183</cites><orcidid>0000-0002-9418-9339</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-024-11116-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-024-11116-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39164437$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhong, Qing</creatorcontrib><creatorcontrib>Zheng, Zi-Fang</creatorcontrib><creatorcontrib>Wu, Dong</creatorcontrib><creatorcontrib>Shang-Guan, Zhi-Xin</creatorcontrib><creatorcontrib>Liu, Zhi-Yu</creatorcontrib><creatorcontrib>Zheng, Lin-Yong</creatorcontrib><creatorcontrib>Lin, Jian-Xian</creatorcontrib><creatorcontrib>Chen, Qi-Yue</creatorcontrib><creatorcontrib>Wang, Jia-Bin</creatorcontrib><creatorcontrib>Xie, Jian-Wei</creatorcontrib><creatorcontrib>Lin, Mi</creatorcontrib><creatorcontrib>Lin, Wei</creatorcontrib><creatorcontrib>Zheng, Chao-Hui</creatorcontrib><creatorcontrib>Huang, Chang-Ming</creatorcontrib><creatorcontrib>Li, Ping</creatorcontrib><title>Developing a modified textbook outcome for elderly patients with gastric cancer: a multi-center study</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Objective
Textbook outcome (TO) is widely recognized as a comprehensive prognostic indication for patients with gastric cancer (GC). This study aims to develop a modified TO (mTO) for elderly patients with GC.
Methods
Data from the elderly patients (aged ≥ 65 years) in two Chinese tertiary referral hospitals were analyzed. 1389 patients from Fujian Medical University Union Hospital were assigned as the training cohort and 185 patients from Affiliated Hospital of Putian University as the validation cohort. Nomogram was developed by the independent prognostic factors of Overall Survival (OS) based on Cox regression.
Results
In the training cohort, laparoscopic surgery was significantly correlated with higher TO rate (
P
< 0.05). Cox regression analysis revealed that surgical approach was also an independent factor of OS (
P
< 0.001), distinct from the traditional TO. In light of these findings, TO parameters were enhanced by the inclusion of surgical approach, rendering a modified TO (mTO). Further analysis showed that mTO, tumor size, pTNM staging, and adjuvant chemotherapy were independent prognostic factors associated with OS (all
P
< 0.05). Additionally, the nomogram incorporating these four indicators accurately predicted 1-, 3-, and 5-year OS in the training cohort, with AUC values of 0.793, 0.814, and 0.807, respectively, and exhibited outstanding predictive performance within the validation cohort.
Conclusion
mTO holds a robust association with the prognosis of elderly patients with GC, meriting intensified attention in efforts aimed at enhancing surgical quality. Furthermore, the predictive model incorporating mTO demonstrates excellent predictive performance for elderly patients with GC.</description><subject>Abdominal Surgery</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Chemotherapy</subject><subject>Clinical outcomes</subject><subject>Endoscopy</subject><subject>Female</subject><subject>Gastrectomy - methods</subject><subject>Gastric cancer</subject><subject>Gastroenterology</subject><subject>Gastrointestinal surgery</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Laparoscopy - methods</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neoplasm Staging</subject><subject>Nomograms</subject><subject>Proctology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Survival Rate</subject><issn>0930-2794</issn><issn>1432-2218</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kctO3TAQhq2KqhygL9AFssSmGxff4sTsEAVaCambsrYSZ3xqSOKD7VDy9jU9XCQWzGYW880_lx-hL4x-Y5TWx4lSqSShXBJWQpHlA1oxKTjhnDU7aEW1oITXWu6ivZRuaOE1qz6hXaGZklLUKwTf4R6GsPHTGrd4DL13Hnqc4SF3IdziMGcbRsAuRAxDD3FY8KbNHqac8F-f_-B1m3L0Ftt2shBPHlXmIXtiCwIRpzz3ywH66NohweenvI-uL85_n_0gV78uf56dXhHLK5WJrhyz2mnXsUo3lqtOud5a2nWWO5BK92C7tqltOd_WmpdipTjjneKy16wR--jrVncTw90MKZvRJwvD0E4Q5mQE1RWrpaSsoEdv0Jswx6lsZwRjomkqpetC8S1lY0gpgjOb6Mc2LoZR82iC2ZpgignmvwlmKU2HT9JzN0L_0vL89QKILZBKaVpDfJ39juw_0NmT3Q</recordid><startdate>20241001</startdate><enddate>20241001</enddate><creator>Zhong, Qing</creator><creator>Zheng, Zi-Fang</creator><creator>Wu, Dong</creator><creator>Shang-Guan, Zhi-Xin</creator><creator>Liu, Zhi-Yu</creator><creator>Zheng, Lin-Yong</creator><creator>Lin, Jian-Xian</creator><creator>Chen, Qi-Yue</creator><creator>Wang, Jia-Bin</creator><creator>Xie, Jian-Wei</creator><creator>Lin, Mi</creator><creator>Lin, Wei</creator><creator>Zheng, Chao-Hui</creator><creator>Huang, Chang-Ming</creator><creator>Li, Ping</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9418-9339</orcidid></search><sort><creationdate>20241001</creationdate><title>Developing a modified textbook outcome for elderly patients with gastric cancer: a multi-center study</title><author>Zhong, Qing ; Zheng, Zi-Fang ; Wu, Dong ; Shang-Guan, Zhi-Xin ; Liu, Zhi-Yu ; Zheng, Lin-Yong ; Lin, Jian-Xian ; Chen, Qi-Yue ; Wang, Jia-Bin ; Xie, Jian-Wei ; Lin, Mi ; Lin, Wei ; Zheng, Chao-Hui ; Huang, Chang-Ming ; Li, Ping</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c256t-95f1c9f9fb1598c26b6fdcc0bbc2fe469decba87c100c792fdc56212b624d9183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Surgery</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Chemotherapy</topic><topic>Clinical outcomes</topic><topic>Endoscopy</topic><topic>Female</topic><topic>Gastrectomy - methods</topic><topic>Gastric cancer</topic><topic>Gastroenterology</topic><topic>Gastrointestinal surgery</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Laparoscopy - methods</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neoplasm Staging</topic><topic>Nomograms</topic><topic>Proctology</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgery</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhong, Qing</creatorcontrib><creatorcontrib>Zheng, Zi-Fang</creatorcontrib><creatorcontrib>Wu, Dong</creatorcontrib><creatorcontrib>Shang-Guan, Zhi-Xin</creatorcontrib><creatorcontrib>Liu, Zhi-Yu</creatorcontrib><creatorcontrib>Zheng, Lin-Yong</creatorcontrib><creatorcontrib>Lin, Jian-Xian</creatorcontrib><creatorcontrib>Chen, Qi-Yue</creatorcontrib><creatorcontrib>Wang, Jia-Bin</creatorcontrib><creatorcontrib>Xie, Jian-Wei</creatorcontrib><creatorcontrib>Lin, Mi</creatorcontrib><creatorcontrib>Lin, Wei</creatorcontrib><creatorcontrib>Zheng, Chao-Hui</creatorcontrib><creatorcontrib>Huang, Chang-Ming</creatorcontrib><creatorcontrib>Li, Ping</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhong, Qing</au><au>Zheng, Zi-Fang</au><au>Wu, Dong</au><au>Shang-Guan, Zhi-Xin</au><au>Liu, Zhi-Yu</au><au>Zheng, Lin-Yong</au><au>Lin, Jian-Xian</au><au>Chen, Qi-Yue</au><au>Wang, Jia-Bin</au><au>Xie, Jian-Wei</au><au>Lin, Mi</au><au>Lin, Wei</au><au>Zheng, Chao-Hui</au><au>Huang, Chang-Ming</au><au>Li, Ping</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Developing a modified textbook outcome for elderly patients with gastric cancer: a multi-center study</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2024-10-01</date><risdate>2024</risdate><volume>38</volume><issue>10</issue><spage>5869</spage><epage>5880</epage><pages>5869-5880</pages><issn>0930-2794</issn><issn>1432-2218</issn><eissn>1432-2218</eissn><abstract>Objective
Textbook outcome (TO) is widely recognized as a comprehensive prognostic indication for patients with gastric cancer (GC). This study aims to develop a modified TO (mTO) for elderly patients with GC.
Methods
Data from the elderly patients (aged ≥ 65 years) in two Chinese tertiary referral hospitals were analyzed. 1389 patients from Fujian Medical University Union Hospital were assigned as the training cohort and 185 patients from Affiliated Hospital of Putian University as the validation cohort. Nomogram was developed by the independent prognostic factors of Overall Survival (OS) based on Cox regression.
Results
In the training cohort, laparoscopic surgery was significantly correlated with higher TO rate (
P
< 0.05). Cox regression analysis revealed that surgical approach was also an independent factor of OS (
P
< 0.001), distinct from the traditional TO. In light of these findings, TO parameters were enhanced by the inclusion of surgical approach, rendering a modified TO (mTO). Further analysis showed that mTO, tumor size, pTNM staging, and adjuvant chemotherapy were independent prognostic factors associated with OS (all
P
< 0.05). Additionally, the nomogram incorporating these four indicators accurately predicted 1-, 3-, and 5-year OS in the training cohort, with AUC values of 0.793, 0.814, and 0.807, respectively, and exhibited outstanding predictive performance within the validation cohort.
Conclusion
mTO holds a robust association with the prognosis of elderly patients with GC, meriting intensified attention in efforts aimed at enhancing surgical quality. Furthermore, the predictive model incorporating mTO demonstrates excellent predictive performance for elderly patients with GC.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>39164437</pmid><doi>10.1007/s00464-024-11116-y</doi><tpages>12</tpages><orcidid>https://orcid.org/0000-0002-9418-9339</orcidid></addata></record> |
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| subjects | Abdominal Surgery Aged Aged, 80 and over Chemotherapy Clinical outcomes Endoscopy Female Gastrectomy - methods Gastric cancer Gastroenterology Gastrointestinal surgery Gynecology Hepatology Humans Laparoscopy Laparoscopy - methods Male Medical prognosis Medicine Medicine & Public Health Neoplasm Staging Nomograms Proctology Prognosis Retrospective Studies Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - surgery Surgery Survival Rate |
| title | Developing a modified textbook outcome for elderly patients with gastric cancer: a multi-center study |
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