Achieving textbook outcomes (TO) and textbook oncological outcomes (TOO) is linked to significantly better overall survival and disease-free survival after gastric and esophageal cancer surgeries.

• For gastrectomy, patients who achieved TO/TOO had a 40% reduction in overall survival risk (HR 0.60) and a 46% reduction in disease-free survival risk (HR 0.54).
• For esophagectomy, the overall survival risk decreased by 31% (HR 0.69) and disease-free survival risk by 31% (HR 0.69).

Standardizing the definitions of TO/TOO could enhance comparability and outcomes in surgical practice.