探讨教科书结果 (TO) 对口腔癌手术患者的长期生存的影响。总共纳入了2011年至2020年间386名行肿瘤切除、颈淋巴结清扫 (ND) 和重建手术的患者。TO 的定义为：切缘无癌细胞侵犯；ND 充分清扫；未在术后3天内紧急就诊；未在术后30天内再次住院；住院时间 ≤22天。采用多元 Cox 回归法评估了 TO 和 5年总生存率 (OS) 之间的关系。TO 率为35%。年龄较轻、颊部亚位点、Charlson 并发症指数为 0、较高的体重指数、较高的血红蛋白和白蛋白、单侧颈淋巴结清扫与较高的 TO 率相关。在所有 TO 患者中，5年 OS 为 70.5%，非 TO 患者为 49.0% (HR，0.47；95% CI，0.31-0.70；p < 0.001)。未达到 TO 与增加的死亡率相关 (aHR，1.73；95% CI，1.14-2.63)，在调整其它因素后，该结果通过倒数概率处理分析得到了验证。TO 对 OS 的影响在年龄 ＜60岁、晚期和 2018 年以前的时间诊断更为显著。在口腔癌手术中未达到 TO 与更差的长期结果相关。TO 可以用作外科手术质量改进的代理指标。© 2023 Wiley Periodicals LLC。

To explore the impact of textbook outcome (TO) on long-term survival in oral cancer surgery.In total, 386 patients with tumor resection, neck dissection (ND), and reconstruction between 2011 and 2020 were included. TO was defined as negative margin; adequate ND; no 3-day emergency room revisit; no 30-day readmission; and length of stay ≤22 days. Multivariate Cox regression was used to evaluate the impact of TO and 5-year overall survival (OS).The TO rate was 35%. Younger age, subsite in buccal area, Charlson Comorbidity Index Score of 0, higher body mass index, higher hemoglobin, higher albumin, and unilateral ND were associated with TO. 5-year OS was 70.5% in overall TO patients and 49.0% in non-TO patients (HR, 0.47; 95% CI, 0.31-0.70; p < 0.001). Non-TO was associated with an increased mortality rate (aHR, 1.73; 95% CI, 1.14-2.63) after adjusting other factors and the result remained robust with inverse probability of treatment weighting analysis. The impact of TO on OS was more significant in age <60, advanced stage, and diagnosis year before 2018.Not achieving TO in oral cancer surgery was associated with worse long-term outcome. TO could be used as a proxy for surgical quality improvement.© 2023 Wiley Periodicals LLC.