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

  • Pancreatic Tumors
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Abstract

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.

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Author information

Author notes

  1. Stefano Partelli and Francesca Fermi share the main authorship.

Authors and Affiliations

  1. Pancreatic and Transplant Surgery Unit, Vita-Salute University, San Raffaele Hospital, Milan, Italy

    Stefano Partelli MD, PhD, Francesca Fermi MD, Domenico Tamburrino MD, PhD & Massimo Falconi MD

  2. Pancreatic Surgery Unit, Pancreas Translational and Clinical Research Center, IRCCS San Raffaele Scientific Institute, Vita-Salute University, San Raffaele Hospital, Milan, Italy

    Stefano Partelli MD, PhD, Francesca Fermi MD, Domenico Tamburrino MD, PhD & Massimo Falconi MD

  3. Department of HPB and Liver Transplant Surgery, Royal Free Hospital, London, UK

    Giuseppe K. Fusai MS & Panagis Lykoudis MD, PhD

  4. Department of Hepato-Pancreato-Biliary Surgery, Pôle des Maladies de l’Appareil Digestif, Université de Paris-Paris Diderot, Beaujon Hospital, Clichy, France

    Nassiba Beghdadi MD, Safi Dokmak MD, PhD & Alain Sauvanet MD

  5. Department of Visceral, Thoracic, and Vascular Surgery, Philipps University, Marburg, Germany

    Dominik Wiese MD & Detlef K. Bartsch MD

  6. Unit of General and Pancreatic Surgery, University and Hospital Trust of Verona, Verona, Italy

    Luca Landoni MD, Federico Reich MD & Roberto Salvia MD, PhD

  7. Department of Surgery, Cancer Center Amsterdam, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands

    O. R. C. Busch MD, PhD, E. J. M. Nieveen van Dijkum MD & Mark G. Besselink MD, PhD

  8. Division of General and Transplant Surgery, University of Pisa, Pisa, Italy

    Niccolò Napoli MD & Ugo Boggi MD

  9. Department of Surgery, Seoul National University College of Medicine, Seoul, South Korea

    Jin-Young Jang MD, Wooil Kwon MD, PhD & Sun-Whe Kim MD

  10. Department of Surgery, University Hospital Southampton, Southampton, UK

    Thomas Armstrong MD, PhD

  11. Department of Surgery, Duke University School of Medicine, Division of Surgical Oncology, Duke Cancer Institute, Durham, NC, USA

    Peter J. Allen MD, FACS

  12. Division of Surgical Oncology, Surgical Oncology, Pathology and Oncology, Johns Hopkins Medical Institution, Baltimore, MD, USA

    Jin He MD, FACS

  13. Department of Surgery, New York University Grossman School of Medicine and NYU-Langone Medical Center, New York, NY, USA

    Ammar Javed MD & Christofer L. Wolfgang MD, FACS

Authors
  1. Stefano Partelli MD, PhD
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  2. Francesca Fermi MD
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Correspondence to Stefano Partelli MD, PhD.

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Partelli, S., Fermi, F., Fusai, G.K. et al. The Value of Textbook Outcome in Benchmarking Pancreatoduodenectomy for Nonfunctioning Pancreatic Neuroendocrine Tumors. Ann Surg Oncol (2024). https://doi.org/10.1245/s10434-024-15114-1

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