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Analysis of textbook outcomes among patients undergoing resection of retroperitoneal sarcoma: A multi-institutional analysis of the US Sarcoma Collaborative. J Surg Oncol 2020 Nov;122(6):1189-1198



Pubmed ID




Scopus ID

2-s2.0-85088290260   1 Citation


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.

Author List

Wiseman JT, Ethun CG, Cloyd JM, Shelby R, Suarez-Kelly L, Tran T, Poultsides G, Mogal H, Clarke C, Tseng J, Roggin KK, Chouliaras K, Votanopoulos K, Krasnick B, Fields R, Walle KV, Ronnekleiv-Kelly S, Howard JH, Cardona K, Grignol V


Callisia N. Clarke MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Follow-Up Studies
Length of Stay
Middle Aged
Prospective Studies
Retroperitoneal Neoplasms
Retrospective Studies
Survival Rate
United States