Analysis of textbook outcomes among patients undergoing resection of retroperitoneal sarcoma: A multi-institutional analysis of the US Sarcoma Collaborative

Jason T. Wiseman, Cecilia G. Ethun, Jordan M. Cloyd, Rita Shelby, Lorena Suarez-Kelly, Thuy Tran, George Poultsides, Harveshp Mogal, Callisia Clarke, Jennifer Tseng, Kevin K. Roggin, Konstantinos Chouliaras, Konstantinos Votanopoulos, Bradley Krasnick, Ryan Fields, Kara Vande Walle, Sean Ronnekleiv-Kelly, John Harrison Howard, Kenneth Cardona, Valerie Grignol

Research output: Contribution to journalArticle

Abstract

Background: The novel composite metric textbook outcome (TO) has increasingly been used as a quality indicator but has not been reported among patients undergoing surgical resection for retroperitoneal sarcoma (RPS) using multi-institutional collaborative data. Methods: All patients who underwent resection for RPS between 2000 to 2016 from eight academic institutions were included. TO was defined as a patient with R0/R1 resection that discharged to home and was without transfusion, reoperation, grade ≥2 complications, hospital-stay >50th percentile, or 90-day readmission or mortality. Univariate and multivariable analyses were performed. Results: Among 627 patients, 56.1% were female and the median age was 59 years. A minority of patients achieved a TO (34.9%). Factors associated with achieving a TO were tumor size <20 cm and low tumor grade, while ASA class ≥3, history of a prior cardiac event, resection of left colon/rectum, distal pancreatic resection, major venous resection and drain placement were associated with not achieving a TO (all P <.05). Achievement of a TO was associated with improved survival (median:12.7 vs 5.9 years, P <.01). Conclusions: Among patients undergoing resection for RPS, failure to achieve TO is common and associated with significantly worse survival. The use of TO may inform patient expectations and serve as a measure for patient-level hospital performance.

Original languageEnglish
JournalJournal of surgical oncology
DOIs
StateAccepted/In press - 2020
Externally publishedYes

Keywords

  • liposarcoma
  • retroperitoneum
  • soft tissue sarcoma

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    Wiseman, J. T., Ethun, C. G., Cloyd, J. M., Shelby, R., Suarez-Kelly, L., Tran, T., Poultsides, G., Mogal, H., Clarke, C., Tseng, J., Roggin, K. K., Chouliaras, K., Votanopoulos, K., Krasnick, B., Fields, R., Walle, K. V., Ronnekleiv-Kelly, S., Howard, J. H., Cardona, K., & Grignol, V. (Accepted/In press). Analysis of textbook outcomes among patients undergoing resection of retroperitoneal sarcoma: A multi-institutional analysis of the US Sarcoma Collaborative. Journal of surgical oncology. https://doi.org/10.1002/jso.26136