Textbook outcome as a predictor of long-term prognosis in ampullary cancer: A retrospective cohort study

doi:10.3748/wjg.122776

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Cohort Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastroenterol. Dec 28, 2026; 32(48): 122776
Published online Dec 28, 2026. doi: 10.3748/wjg.122776

Table 2 Factors associated with overall survival and disease-free survival identified by univariable and multivariable Cox regression, median (interquartile range)

Characteristic	OS¹		DFS¹		OS²		DFS²
Characteristic	HR	P value	HR	P value	HR	P value	HR	P value
TO achievement
No	Reference		Reference
Yes	0.50 (0.36, 0.68)	< 0.001^a	0.61 (0.46, 0.81)	< 0.001^a	0.61 (0.44, 0.84)	0.002^a	0.75 (0.56, 0.99)	0.044^a
Sex
Female	Reference		Reference
Male	0.91 (0.67, 1.24)	0.606	0.87 (0.65, 1.17)	0.355
Age (years)	1.02 (1.00, 1.03)	0.064	1.01 (1.00, 1.03)	0.157
Tumor differentiation
Well	Reference		Reference
Poor	2.89 (2.12, 3.94)	< 0.001^a	2.19 (1.65, 2.89)	< 0.001^a	1.56 (1.11, 2.19)	0.011^a	1.24 (0.91, 1.70)	0.249
T-stage
T1	Reference		Reference
T2	1.97 (0.88, 4.42)	0.102	1.81 (0.99, 3.30)	0.054^a	1.73 (0.76, 3.90)	0.202	1.66 (0.90, 3.04)	0.106
T3a	4.00 (1.79, 8.94)	< 0.001^a	2.78 (1.50, 5.14)	< 0.001^a	3.11 (1.38, 7.04)	0.006^a	2.37 (1.27, 4.43)	0.007^a
T3b	11.0 (4.97, 24.1)	< 0.001^a	6.81 (3.72, 12.5)	< 0.001^a	5.79 (2.53, 13.2)	< 0.001^a	4.00 (2.11, 7.57)	< 0.001^a
T4	18.7 (6.83, 51.3)	< 0.001^a	11.3 (4.85, 26.2)	< 0.001^a	6.35 (2.20, 18.4)	< 0.001^a	4.29 (1.75, 10.5)	0.001^a
N-stage
N0	Reference		Reference
N1	2.71 (1.92, 3.81)	< 0.001^a	2.37 (1.75, 3.22)	< 0.001^a	1.94 (1.33, 2.82)	< 0.001^a	1.88 (1.34, 2.66)	< 0.001^a
N2	6.73 (4.22, 10.7)	< 0.001^a	6.81 (4.35, 10.7)	< 0.001^a	2.86 (1.67, 4.91)	< 0.001^a	3.31 (1.96, 5.58)	< 0.001^a
Perineural invasion	2.34 (1.46, 3.73)	< 0.001^a	2.11 (1.35, 3.32)	< 0.001^a	1.74 (1.06, 2.86)	0.028^a	1.63 (1.02, 2.60)	0.042^a
Preoperative raised serum CA19-9 (> 37 U/mL)	1.79 (1.28, 2.51)	< 0.001^a	1.84 (1.36, 2.48)	< 0.001^a	1.47 (1.04, 2.08)	0.028^a	1.63 (1.20, 2.21)	0.002^a
Preoperative raised serum CEA (> 5 ng/mL)	0.95 (0.63, 1.41)	0.753	0.82 (0.57, 1.20)	0.279
Operation method
OPD	Reference		Reference
LPD	1.05 (0.77, 1.43)	0.848	1.09 (0.82, 1.43)	0.538
Tumor size (cm)	1.10 (0.99, 1.22)	0.078	1.05 (0.95, 1.16)	0.429
Positive resection margin	3.74 (2.21, 6.32)	< 0.001^a	3.17 (1.89, 5.32)	< 0.001^a	2.26 (1.28, 3.98)	0.005^a	1.78 (1.00, 3.14)	0.048^a
Additional organ resection	1.10 (0.45, 2.68)	0.831	0.89 (0.37, 2.17)	0.802

¹Univariable analysis.

²Multivariable analysis.

^aP <0.05.

OS: Overall survival; DFS: Disease-free survival; TO: Textbook outcome; CA19-9: Carbohydrate antigen 19-9; CEA: Carcinoembryonic antigen; OPD: Open pancreaticoduodenectomy; LPD: Laparoscopic pancreaticoduodenectomy.

Full Size Table

Citation: Guo XY, Zhang JZ, Guo T, Huang XR, Zhu DS, Zhang Z, Zheng H, Yu YH, Zhang ZW. Textbook outcome as a predictor of long-term prognosis in ampullary cancer: A retrospective cohort study. World J Gastroenterol 2026; 32(48): 122776
URL: https://www.wjgnet.com/1007-9327/full/v32/i48/122776.htm
DOI: https://dx.doi.org/10.3748/wjg.122776

Guo XY, Zhang JZ, Guo T, Huang XR, Zhu DS, Zhang Z, Zheng H, Yu YH, Zhang ZW. Textbook outcome as a predictor of long-term prognosis in ampullary cancer: A retrospective cohort study. World J Gastroenterol 2026; 32(48): 122776 [DOI: 10.3748/wjg.122776]

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