Novel definition of textbook outcome in biliary system cancers and its influence on patients' survival and quality of life

Q: What is the main goal of the study on textbook outcome in biliary system cancers?

To expand the concept of textbook outcome and examine how it is associated with patients’ survival and quality of life.

Q: How does the study define “textbook outcome”?

It uses a novel “all or none” definition based on rapid postoperative recovery indicators combined with short-term mortality, readmission, prolonged stay, surgical margin, and postoperative complications.

Q: What outcomes are reported as associated with achieving textbook outcome?

Textbook outcome is associated with improved survival in certain subgroups and with better basic daily performance, social life performance, and personal evaluation, leading to improved quality of life.

Sep 21, 2026

Upload by Olivia Brown

Background: The definition of textbook outcome in biliary system cancers is a developing concept requiring expansion and investigation of its relationship with survival and quality of life. Methods: The study proposes a novel “all or none” textbook outcome definition using postoperative recovery indicators plus short-term mortality, readmission, prolonged stay, margin status, and complications. Patients were classified into textbook outcome and non-textbook outcome groups, and survival and a customized quality-of-life questionnaire were analyzed for association.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Biliary system cancers and treatment challenges

Need for an effective assessment system

Keywords

DOI: 10. 1002/cam4 .7186 RESEAR CH ARTICLE Novel definition of textbook outcome in biliary system cancers and its influence on patients' survival and quality of life Manar Mikhail Atyah | Li Xu | Zhiying Yang Department of Hepatobiliary and Pancreatic Surgery, China–Japan Friendship Hospital, Beijing, China Correspondence Zhiying Yang and Li Xu, Department of Hepatobiliary Surgery, China– Japan Friendship Hospital, 2 East Yinghuayuan Street, Chaoyang District, Beijing 100029, China. [Email:](Email: yangzhy@aliyun.com)[ yangzhy@aliyun.com](Email: yangzhy@aliyun.com) and [thinnerxl@sina.com](thinnerxl@sina.com) Funding information National Key Clinical Specialty Discipline Construction Program of China, Grant/Award Number: 2021QLT004 Abstract Background: The definition of textbook outcome in biliary system cancers is a developing concept in need of expansion and investigation of its association with survival and quality of life. Methods: In this original research, we developed a novel “all or none” textbook outcome definition which addresses the rapid recovery of post-surgical indexes, in addition to short-term mortality, hospital re-admission, prolonged stay, surgical margin and postoperative complications. Based on the fulfillment of relevant criteria, patients were divided into textbook outcome and non-textbook outcome groups and their characteristics and survival data were analyzed. A customized“quality of life” questionnaire was developed to address short-term recovery and post-discharge life quality of patients. Association with quality of life improvement was then investigated. Results: A total of 129 patients were included. Textbook outcome was achieved in 25.58% of patients (37.04% of gallbladder cancer patients and 17.8% of cholangiocarcinoma patients). Compared to non-textbook outcome group, patients with textbook outcome had lower rate of pre-operative biliary drainage (p = 0.026), higher rate of normal preoperative liver function (p <0.001) and tumor markers (p = 0.001), reduced perioperative bleeding (p = 0.006) and blood transfusion (p = 0.005), and higher rate of N0 stage cases (p = 0.008) . Textbook outcome was also associated with enhanced survival, significantly in older patients (<65years)(1-year survival rate: 100% vs. 78.57%(p = 0.108), 2-year survival rate: 87.5% vs. 44%(p = 0.046)) . Finally, textbook outcome was significantly associated with enhanced basic daily performance (p <0.001), social life performance (p = 0.033), and personal evaluation (p <0.001), and thus improved quality of life (p <0.001) . Conclusions: The novel definition of textbook outcome was able to address the specific nature of recovery after resection of biliary system cancers. Expanding the scope of textbook outcome and addressing the influence on survival and quality of life provides a comprehensive concept able to reflect physical, psychological and functioning enhancements in patients recovery. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. Cancer Medicine. 2024;13:e7186 . [https://doi.org/10.1002/cam4.7186](https://doi.org/10.1002/cam4.7186) [wileyonlinelibrary.com/journal/cam4](wileyonlinelibrary.com/journal/cam4) 1 of 10 KEYWORDS biliary system cancer, quality of life, surgery, survival, textbook outcome 1 | INTRODUCTION The biliary system is an essential part of the human body and includes the biliary tract and gallbladder. Its main function is to store and deliver the bile secreted by the liver to the duodenum. Similar to other systems of the human body, the biliary system is susceptible to carcinogenic changes. Cancers of the biliary tract are known as cholangiocarcinomas (CC) and are divided, based on the section of the tract, into intrahepatic (ICC) an

FAQs

What is the main goal of the study on textbook outcome in biliary system cancers?

To expand the concept of textbook outcome and examine how it is associated with patients’ survival and quality of life.

How does the study define “textbook outcome”?

It uses a novel “all or none” definition based on rapid postoperative recovery indicators combined with short-term mortality, readmission, prolonged stay, surgical margin, and postoperative complications.

What outcomes are reported as associated with achieving textbook outcome?

Textbook outcome is associated with improved survival in certain subgroups and with better basic daily performance, social life performance, and personal evaluation, leading to improved quality of life.

Sep 21, 2026

Upload by Olivia Brown