eP342 - Identifying Causes of Failure to Achieve Textbook Oncologic Outcome in Colon Cancer Management at a Safety-net Hospital System

Author(s)

• SM

  Stefania Montero, MD

  Research Fellow
  Harbor-UCLA Medical Center, Department of Surgery. Torrance, CA, USA
  Torrance, California, United States

  Disclosure information not submitted.

ePoster Presenter(s)

• 

  Erik T. Pihl, MD (he/him/his)

  Resident
  Harbor-UCLA Medical Center, Department of Surgery
  Harbor UCLA Medical Center
  Torrance, CA, United States

  Disclosure information not submitted.

Author(s)

• HK

  Hye Kwang E. Kim, B.S.

  Medical Student
  Midwestern University - Chicago College of Osteopathic Medicine
  Torrance, California, United States

  Disclosure information not submitted.
• TR

  Tara A. Russell, MD, MPH, PhD

  Assistant Professor
  University of California Los Angeles
  Los Angeles, California, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.
• BP

  Beverley A. Petrie, MD, FACS, FASCRS

  Executive Vice Chair, Department of Surgery
  Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, CA
  Torrance, California, United States

  Disclosure information not submitted.

Senior Author(s)

• 

  Hanjoo Lee, MD, MS, FACS

  Assistant Professor of Surgery
  Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, CA
  UCLA School of Medicine
  Torrance, California, United States

  All relevant financial disclosures have been managed and will be listed below.
  This individual has no financial relationships with ineligible companies.

Purpose/Background: Colorectal Cancer (CC) is the second most common cause of cancer-related deaths. Textbook Oncologic Outcome (TOO) is a composite metric for optimal results after resection for CC. We sought to identify factors associated with failure to achieve CC-TOO.Methods/Interventions: A retrospective chart review was performed within our safety-net system from 2018-2022. Adults with stage I-III CC who underwent resection were included. Primary outcome was TOO rate, composed of R0 resection, ≥12 lymph nodes retrieve, no 30-day readmission or mortality, length of stay (LOS) < 75 percentile by procedure type and adjuvant chemotherapy < 120 days diagnosis when indicated. Secondary outcome was causes of failure to achieve TOO.Results/Outcomes: 190 patients met inclusion criteria. TOO rate was 63.7%. Most common causes of failure to achieve TOO was SBO/Ileus (19%), inadequate lymph node retrieved (16%), anastomotic leak (11%), bleeding (11%), and infectious complications (10%). No demographic factor was associated with failure to achieve TOO.Conclusion/

Discussion: 36.% of patients failed to achieve TOO, primarily driven by surgical complications and inadequate lymph nodes retrieved on resection. Efforts are needed to improve perioperative outcomes and adhere to oncologically sound resection techniques.Causes of Failure to Achieve TOO