Multicentric national Italian analysis of textbook outcome in colorectal cancer surgery: The ATOCCS Study protocol on behalf of the Italian Surgical Association (ACOI, Associazione Chirurghi Ospedalieri Italiani)
Background: Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide. Despite advancements in surgical techniques and perioperative care, patient outcomes vary significantly across healthcare institutions. Textbook outcome (TO), a composite metric representing an ideal postoperative course, has been proposed as a standard for assessing the quality of surgical care in CRC. However, its impact on patient outcomes remains underexplored, particularly across diverse clinical settings. Objective: This study aims to explore surgeons’ adherence to TO criteria and identify patient-specific and procedural risk factors associated with TO failure. The study will also evaluate TO as a quality metric in CRC surgery, examining its association with short-term and long-term clinical outcomes in a multicenter cohort. Methods: This multicenter, retrospective cohort study will include all adult patients undergoing CRC resection between 1 January 2022 and 31 December 2024 across multiple centers in Italy, on behalf of the Italian Surgical Association (ACOI, Associazione Chirurghi Ospedalieri Italiani). The study will collect and analyze demographic, clinical, and surgical data to determine TO incidence and its association with key outcomes, including radical resection, 30-day mortality, morbidity, no reintervention, no ostomy placement, and a hospital stay of 14 days or less. Conclusions: This study will offer valuable insights into the utility of TO as a metric for evaluating the quality of care in CRC surgery. These findings may inform future guidelines and policies aimed at improving CRC surgical outcomes.
Authors
- Giuseppe Lamacchia
- Antonio Azzinnaro (ORCID: https://orcid.org/0000-0002-5725-4728)
- Michele Motter (ORCID: https://orcid.org/0009-0000-4635-2181)
- Gianluigi Luridiana (ORCID: https://orcid.org/0000-0001-5009-6387)
- Giovanni Ciaccio
- Felice Borghi (ORCID: https://orcid.org/0000-0002-2431-2020)
- Pietro Lombari
- Luigi Ricciardelli
- Marco Catarci (ORCID: https://orcid.org/0000-0002-6338-0114)
- Gianluca Garulli (ORCID: https://orcid.org/0000-0002-6023-6117)
- Nicola Cillara (ORCID: https://orcid.org/0000-0001-6877-2267)
- Massimo Basti (ORCID: https://orcid.org/0000-0001-5369-9335)
- Vincenzo Bottino (ORCID: https://orcid.org/0000-0002-5846-9990)
- Jacopo Andreuccetti (ORCID: https://orcid.org/0000-0003-0474-9775)
- Alessio Giordano (ORCID: https://orcid.org/0000-0002-9505-791X)
- Marco Scatizzi (ORCID: https://orcid.org/0000-0002-0753-9450)
- Antonio Brillantino (ORCID: https://orcid.org/0000-0002-0198-8511)
- Manuela Cuoghi (ORCID: https://orcid.org/0000-0003-3401-1093)
- Giànandrea Baldazzi (ORCID: https://orcid.org/0000-0002-7471-4749)
- Pasquale Castaldo (ORCID: https://orcid.org/0009-0006-8860-5590)
- Pierluigi Marini (ORCID: https://orcid.org/0000-0002-6823-9451)
- Paolo Ciano (ORCID: https://orcid.org/0000-0003-0617-6800)
- Maurizio Pavanello
- Massimo Farina (ORCID: https://orcid.org/0000-0002-5370-2693)
- Michela Mineccia (ORCID: https://orcid.org/0000-0002-7363-8609)
- Chiara Ranucci
- Luigi Marano (ORCID: https://orcid.org/0000-0002-9833-8055)
- Grazia Maria Attinà
- Mariano Fortunato Armellino (ORCID: https://orcid.org/0000-0002-9043-0228)
Institutions
- Azienda Ospedaliera San Giovanni Addolorata (IT)
- Ente Ospedaliero Ospedali Galliera (IT)
- Ospedale Santa Chiara (IT)
- ASL Roma (IT)
- AULSS 2 Marca Trevigiana (IT)
- Nuovo Ospedale San Giovanni di Dio (IT)
- Fatebenefratelli Hospital (IT)
- Azienda Ospedaliero-Universitaria Careggi (IT)
- Santissima Trinità (IT)
- ASST Melegnano e della Martesana (IT)
- Ospedale Infermi di Rimini (IT)
- Ospedale Sandro Pertini (IT)
- Ospedale Monaldi (IT)
- Ospedale Regina Apostolorum (IT)
- Candiolo Cancer Institute (IT)
- Carlo Forlanini Hospital (IT)
- Azienda Ospedaliera G. Brotzu (IT)
- Aziende Socio Sanitarie Territoriale Ovest Milanese
- University of Brescia (IT)
Publication Details
- Journal
- Il Giornale di Chirurgia - Journal of the Italian Association of Hospital Surgeons
- Published
- 2024-12-01
- DOI
- https://doi.org/10.1097/ia9.0000000000000063
- Citations
- 1
- Primary Topic
- Colorectal Cancer Surgical Treatments
- Type
- article
- Field-Weighted Citation Impact
- 0.28