Incidence and impact of Textbook Outcome among patients undergoing resection of pancreatic neuroendocrine tumors: Results of the US Neuroendocrine Tumor Study Group

摘要

Abstract Background and Objectives We sought to define the incidence and impact of Textbook Outcome (TO) on disease‐free?survival [DFS] among patients undergoing resection of pancreatic neuroendocrine tumors (PNET). Methods Patients undergoing resection of a PNET between 2000 and 2016 were identified using a multi‐institutional database. TO was defined as no postoperative severe complications (Clavien‐Dindo grade?≥?III), no 90‐day mortality, no prolonged length‐of‐hospital stay (LOS) (ie, ?75th percentile), no 90‐day readmission after discharge, and R0 resection. The 5‐year DFS was calculated and the association with TO was examined. Results Among 821 patients with a PNET, median tumor size was 2.1?cm (IQR 1.4‐14.6). Resection consisted of pancreatoduodenectomy (PD) (n?=?231, 28.1%), distal pancreatectomy (DP) (n?=?492, 59.9%), and enucleation (EN) (n?=?98, 11.9%). Overall TO rate was 49.3% (n?=?405). The incidence of TO varied by procedure type (PD: 32.5% vs DP: 56.7% vs EN: 52.0%; P ??.001). After adjusting for all competing factors, achievement of a TO was independently associated with improved DFS (hazard ratio: 0.54, 95% CI, 0.35‐0.81; P ?=?.003). Conclusions Only one in two patients undergoing resection of a PNET achieved a TO, which varied markedly based on procedure type. Achievement of a TO was associated with improved DFS.