Impact of Textbook Outcome (TO) and Textbook Oncological Outcome (TOO) on Survival Following Surgery for Esophagogastric Cancer: A Systematic Review and Meta-analysis.

Median achievement rates were 51.5% (IQR 34.3-60.5%) for gastrectomy and 35.1% (IQR 30.7-50.8%) for esophagectomy.

DFS was improved in patients achieving textbook outcome/textbook oncological outcome following gastrectomy (HR 0.54; 95% CI 0.42-0.70) and esophagectomy (HR 0.69; 95% CI 0.61 to 0.79).

Heterogeneity was almost eliminated when pooling studies using a standardized textbook outcome definition (OS in gastrectomy: I 2 : 1%, P = 0.41; OS in esophagectomy: I 2 : 0%, P = 0.28).

Median 1-, 3-, and 5-year OS and DFS rates were consistently higher in patients achieving textbook outcome/textbook oncological outcome.