Patient-Level Comparison of Surgical TOGS Components and DUCA-Based Textbook Outcome After Open D2 Total Gastrectomy

Background and Objectives: Textbook outcome (TO) is increasingly used as a composite quality metric in gastric cancer surgery, but different TO frameworks can classify the same patient differently. This study compared surgical and perioperative components of the Textbook Outcome in Gastric Surgery (TOGS) framework with the Original Dutch Upper Gastrointestinal Cancer Audit textbook outcome (Original DUCA-TO) and a Modified DUCA-TO definition using Clavien–Dindo (CD) grade ≥III as the morbidity threshold, focusing on patient-level agreement and discordance.