Textbook outcomes in the liver-first approach for colorectal liver metastases: prospective multicentre analysis

Background: Textbook outcome is a valuable tool for assessing surgical outcomes. The aim of this study was to analyse textbook-outcome rates in the prospective Spanish National Registry of the Liver-First Approach (RENACI Project) and the factors influencing textbook-outcome achievement. Additionall...

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Detalles Bibliográficos
Autores: Ramia, J.M., Villodre-Tudela, C., Falgueras-Verdaguer, L., Zambudio-Carroll, N., Castell-Gómez, J.T., Carbonell-Morote, S., Blas-Laina, J.L., Borrego-Estella, V., Sánchez-Pérez, B., Serradilla-Martín, M., Domingo-Del-Pozo, C., García-Plaza, G., González-Rodríguez, F.J., Montalvá-Orón, E.M., Moya-Herraiz, Á., Paterna-López, S., Suárez-Muñoz, M.A., Alkorta-Zuloaga, M., Blanco-Fernández, G., Dabán-Collado, E., Gómez-Bravo, M.A., Miota-De-Llamas, J.I., Rotellar, F., Sánchez-Cabús, S., Pacheco-Sánchez, D., Rodríguez-Sanjuán, J.C., Varona-Bosque, M.A., Carrión-Álvarez, L., de la Serna-Esteban, S., Dopazo-Taboada, C., Martín-Pérez, E., Martínez-Cecilia, D., Castro-Santiago, M.J., Dorcaratto, D., Gutiérrez-Díaz, M.L., Asencio-Pascual, J.M., Burdío-Pinilla, F., Carracedo-Iglesias, R., Escartín-Arias, A., Ielpo, B., Rodríguez-Laiz, G., Valdivieso-López, A., De-Vicente-López, E., Alonso-Orduña, V.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:dnet:r-fisabio___::194827e6943783b080c39e03ae0f193b
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/21047
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85183336741&doi=10.1093%2fbjsopen%2fzrad123&partnerID=40&md5=d36aa5d5021efc691c1ef7bf4398edf5
Access Level:acceso abierto
Palabra clave:Colorectal Neoplasms
Humans
Liver Neoplasms
Postoperative Complications
Prospective Studies
Retrospective Studies
CA 19-9 antigen
carcinoembryonic antigen
adult
aged
American Society of Anaesthesiologists score
arterial embolization
Article
ascending colon
blood transfusion
body height
body weight
cancer chemotherapy
cancer radiotherapy
cancer recurrence
cancer staging
cancer surgery
colorectal cancer
colorectal liver metastasis
colostomy
cross clamp time
descending colon
female
follow up
hepatectomy
hepatic artery ligation
hospital readmission
hospitalization
human
laparoscopy
length of stay
liver metastasis
major clinical study
male
metastasis
morbidity
mortality
multicenter study
neoadjuvant chemotherapy
open surgery
operative blood loss
outcome assessment
postoperative complication
prospective study
rectum
retrospective study
segmentectomy
sigmoid
trisectionectomy
tumor regression
tumor volume
volumetry
clinical trial
colore
Descripción
Sumario:Background: Textbook outcome is a valuable tool for assessing surgical outcomes. The aim of this study was to analyse textbook-outcome rates in the prospective Spanish National Registry of the Liver-First Approach (RENACI Project) and the factors influencing textbook-outcome achievement. Additionally, a model for assessing a procedure-specific textbook outcome for the liver-first approach was proposed. Methods: A retrospective analysis of a prospective and multicentre database that included consecutive patients with colorectal cancers and synchronous liver metastases who underwent a liver-first approach between June 2019 and August 2020 was performed. Two types of textbook outcome were measured: classic textbook outcome and liver-first-approach-specific textbook outcome (which included negative margins, no perioperative transfusion, no postoperative major surgical complications, no prolonged length of hospital stay, no readmissions, no mortality, and full treatment completion). The primary endpoint was textbook-outcome rate for a liver-first approach at 90 days. Results: A total of 149 patients were included in the analysis. Classic and liver-first-approach-specific textbook-outcome rates were 71.8 per cent (107 patients) and 46 per cent (69 patients) respectively. Factors significantly associated with liver-first-approach-specific textbook-outcome achievement in the multivariable analysis were the number of metastases (OR 0.82 (95 per cent c.i. 0.73 to 0.92); P = 0.001) and intraoperative blood loss (OR 0.99 (95 per cent c.i. 0.99 to 1.00); P = 0.007). Prolonged length of hospital stay (33 patients, 41 per cent), positive margins (31 patients, 39 per cent), perioperative transfusion (27 patients, 34 per cent), and no full treatment completion (18 patients, 23 per cent) were the items that most frequently prevented liver-first-approach-specific textbook-outcome achievement. Conclusion: Liver-first-approach-specific textbook outcome is a promising tool for measuring the quality of care when using the liver-first approach for synchronous colorectal liver metastases. © The Author(s) 2024.

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