Return to intended oncologic treatment (RIOT): A novel metric for evaluating the quality of oncosurgical therapy for malignancy

• DOI: 10.1002/jso.23626
• Publication Date: 2014-05-21T08:08:42Z
• Authors: Thomas A. Aloia; Giuseppe Zimmitti; Claudius Conrad; Vijaya Gottumukalla; Scott Kopetz; Jean-Nicolas Vauthey
• Keywords: Adult; Aged, 80 and over; Male; Liver Neoplasms; Antineoplastic Agents; Middle Aged; 16. Peace & justice; Disease-Free Survival; Neoadjuvant Therapy; 3. Good health; 03 medical and health sciences; Logistic Models; Postoperative Complications; 0302 clinical medicine; Chemotherapy, Adjuvant; Multivariate Analysis; Hepatectomy; Humans; Minimally Invasive Surgical Procedures; Female; Colorectal Neoplasms; Aged; Quality Indicators, Health Care; Retrospective Studies

Background After cancer surgery, complications, and disability prevent some patients from receiving subsequent treatments. Given that an inability to complete all intended therapies might negate the oncologic benefits of surgical therapy, strategies improve return treatment (RIOT), including minimally invasive surgery (MIS), are being investigated. Methods This project was designed evaluate liver tumor determine RIOT rate, risk factors for RIOT, its impact on survivals. Outcomes a homogenous cohort 223 who underwent open-approach metachronous colorectal metastases group 27 treated with MIS hepatectomy were examined. Results Of patients, 167 offered postoperative yielding rate 75%. The remaining 56 (25%) unable receive further due complications (n = 29 pts) or poor performance status pts). Risk associated hypertension (OR 2.2, P 0.025), multiple preoperative chemotherapy regimens 5.9, 0.039), 2.0, 0.039). Inability correlated shorter disease-free overall survivals (P < 0.001, HR 2.16; 0.005, 2.07, respectively). In contrast open group, 100% initiate therapy did so 0.038) within median time interval (MIS: 15 days vs. open: 42 days; 0.001). Conclusions relationship between long-term outcomes suggests rates both open- MIS-approach should routinely be reported as quality indicator. J. Surg. Oncol. 2014; 110:107–114. © 2014 Wiley Periodicals, Inc.