Textbook Outcome After Esophagectomy for Esophageal Cancer: Current Evidence and Future Perspectives

Abstract

Esophagectomy is an essential treatment for resectable esophageal cancer. However, perioperative morbidity and mortality are higher and postoperative hospital stay is longer than other gastrointestinal malignancies. However, quality of perioperative surgical course affects both short- and long-term oncological outcomes in various malignancies. Recently, textbook outcome (TO)/textbook oncological outcome (TOO) are developed to evaluate quality of perioperative surgical course. TO/TOO included various perioperative elements and introduced in various malignancies. In esophageal cancer surgery, in 2017, TO for esophageal cancer (EC) defined and included 10 short-term surgical outcomes (curative resection, no intraoperative complications, R0 resection, number of harvest lymph node, no sever postoperative complication, no reintervention, no readmission intensive care unit, no readmission, no prolonged hospital stay, and no mortality). In 2021, TO for EC redefinition was made and included nine revised short-term surgical parameters. Previous studies demonstrated that achieved TO associated with better survival after esophagectomy for EC. To optimize esophagectomy for EC, it is necessary to understand the characteristics of each study before the widespread implementation of TO in clinical practice. This review summarizes the background, current status, and future perspectives of TO for resectable EC.