The Value of Textbook Outcome in Benchmarking Pancreatoduodenectomy for Nonfunctioning Pancreatic Neuroendocrine Tumors

期刊论文
发表日期：

2024年3月10日

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Stefano Partelli,
Francesca Fermi,
Giuseppe K. Fusai,
Domenico Tamburrino,
Panagis Lykoudis,
Nassiba Beghdadi,
Safi Dokmak,
Dominik Wiese,
Luca Landoni,
Federico Reich,
O. R. C. Busch,
Niccolò Napoli,
Jin-Young Jang,
Wooil Kwon,
Thomas Armstrong,
Peter J. Allen,
Jin He,
Ammar Javed,
Alain Sauvanet,
Detlef K. Bartsch,
Roberto Salvia,
E. J. M. Nieveen van Dijkum,
Mark G. Besselink,
Ugo Boggi,
Sun-Whe Kim,
Christofer L. Wolfgang,
Massimo Falconi

摘要

Background

Textbook outcome (TO) is a composite variable that can define the quality of pancreatic surgery. The aim of this study is to evaluate TO after pancreatoduodenectomy (PD) for nonfunctioning pancreatic neuroendocrine tumors (NF-PanNETs).

Patients and Methods

All patients who underwent PD for NF-PanNETs (2007–2016) in different centers were included in this retrospective study. TO was defined as the absence of severe postoperative complications and mortality, length of hospital stay ≤ 19 days, R0 resection, and at least 12 lymph nodes harvested.

Results

Overall, 477 patients were included. The TO rate was 32%. Tumor size [odds ratio (OR) 1.696; p = 0.013], a minimally invasive approach (OR 12.896; p = 0.001), and surgical volume (OR 2.062; p = 0.023) were independent predictors of TO. The annual frequency of PDs increased over time as well as the overall rate of TO. At a median follow-up of 44 months, patients who achieved TO had similar disease-free (p = 0.487) and overall survival (p = 0.433) rates compared with patients who did not achieve TO. TO rate in patients with NF-PanNET > 2 cm was 35% versus 27% in patients with NF-PanNET ≤ 2 cm (p = 0.044). Considering only NF-PanNETs > 2 cm, patients with TO and those without TO had comparable 5-year overall survival rates (p = 0.766)

Conclusions

TO is achieved in one-third of patients after PD for NF-PanNETs and is not associated with a benefit in terms of long-term survival.