教科书肿瘤结果（TOO）已在外科肿瘤学中得到验证，作为与肿瘤结果相关的综合质量指标。我们的目的是评估接受晚期上皮性输卵管卵巢癌 (AEOC) 初级治疗的患者中 TOO 与总生存期 (OS) 之间的关联。国家癌症数据库 (NCDB) 中确定了 2008 年至 2019 年间接受 AEOC 手术的患者。初次减瘤手术（PDS）和间隔减瘤手术（IDS）队列分别进行了分析。 TOO 的定义是实现完全减瘤、住院时间<10 天、30 天无再入院、90 天内无死亡以及 42 天内开始辅助化疗。使用 Kaplan-Meier 方法通过 TOO 状态和 Cox 回归来估计 5 年 OS，以评估 TOO 与 5 年内死亡之间的关系。总共纳入 21,657 名患者：PDS 队列中 51.4%，PDS 队列中 48.6% IDS 队列。 20.5% 的 PDS 队列和 39.2% 的 IDS 队列实现了 TOO (TOO )。对于 PDS 队列，实现 TOO 与改善 5 年 OS 相关：59.0% TOO 与 39.5% TOO-（HR 0.53，95% CI 0.49-0.57）。对于 IDS 队列，5 年 OS 也有类似的获益：43.9% TOO 与 31.2% TOO-（HR 0.67，95% CI 0.63-0.70）。多变量分析表明，在 PDS 队列（HR 0.58，95% CI 0.54-0.62）和 IDS 队列（HR 0.69，95% CI 0.65-0.73）中，实现 TOO 的患者 5 年内死亡风险较低。综合测量与改善长期生存相关，并且对于接受 AEOC 初级治疗的患者来说可能是一个有用的质量评估工具，无论手术时机如何。该工具反映了使用多学科方法提供基于风险的个性化决策的能力。版权所有 © 2024 Elsevier Inc. 保留所有权利。

Textbook oncologic outcome (TOO) has been validated in surgical oncology as a composite quality measure correlated with oncologic outcomes. We aimed to assess the association between TOO and overall survival (OS) in patients undergoing primary treatment for advanced epithelial tubo-ovarian cancer (AEOC).Patients undergoing surgery for AEOC between 2008 and 2019 were identified in the National Cancer Database (NCDB). Primary debulking surgery (PDS) and interval debulking surgery (IDS) cohorts were analyzed separately. TOO was defined as achieving complete debulking, length of hospital stay <10 days, no 30-day readmission, no death within 90 days, and initiation of adjuvant chemotherapy within 42 days. The Kaplan-Meier method was used to estimate 5-year OS by TOO status and Cox regression to evaluate the relationship between TOO and death within 5 years.A total of 21,657 patients were included: 51.4% in the PDS cohort and 48.6% in the IDS cohort. TOO was achieved (TOO+) in 20.5% of the PDS cohort and 39.2% of the IDS cohort. For the PDS cohort, achieving TOO was associated with improved 5-year OS: 59.0% TOO+ vs. 39.5% TOO- (HR 0.53, 95% CI 0.49-0.57). For the IDS cohort, a similar benefit was seen for 5-year OS: 43.9% TOO+ vs. 31.2% TOO- (HR 0.67, 95% CI 0.63-0.70). Multivariable analysis demonstrated that patients achieving TOO were at lower risk of death within 5 years in both the PDS cohort (HR 0.58, 95% CI 0.54-0.62) and the IDS cohort (HR 0.69, 95% CI 0.65-0.73).The TOO composite measure is associated with improved long-term survival and could be a useful quality assessment tool for patients undergoing primary treatment for AEOC, irrespective of surgical timing. This tool reflects the ability to deliver risk-based individualized decision-making using a multidisciplinary approach.Copyright © 2024 Elsevier Inc. All rights reserved.