Validation of the Surgical Outcome Risk Tool (SORT) and SORT v2 for Predicting Postoperative Mortality in Patients with Pancreatic Cancer Undergoing Surgery.

Autor: Karamolegkou AP; Department of Anesthesiology, Hippocration General Hospital of Athens, 11527 Athens, Greece., Fergadi MP; Department of Radiology, University of Thessaly, Biopolis, 38221 Larissa, Greece., Magouliotis DE; Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London WC1E 6AU, UK.; Department of Surgery, University of Thessaly, Biopolis, 41110 Larissa, Greece., Samara AA; Department of Surgery, University of Thessaly, Biopolis, 41110 Larissa, Greece., Tatsios E; Department of Surgery, University of Thessaly, Biopolis, 41110 Larissa, Greece., Xanthopoulos A; Department of Cardiology, University of Thessaly, 38221 Larissa, Greece., Pourzitaki C; Department of Clinical Pharmacology, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece., Walker D; Division of Surgery and Interventional Science, Faculty of Medical Sciences, University College London, London WC1E 6AU, UK., Zacharoulis D; Department of Surgery, University of Thessaly, Biopolis, 41110 Larissa, Greece.
Jazyk: angličtina
Zdroj: Journal of clinical medicine [J Clin Med] 2023 Mar 16; Vol. 12 (6). Date of Electronic Publication: 2023 Mar 16.
DOI: 10.3390/jcm12062327
Abstrakt: Background: Pancreatic cancer surgery is related to significant mortality, thus necessitating the accurate assessment of perioperative risk to enhance treatment decision making. A Surgical Outcome Risk Tool (SORT) and SORT v2 have been developed to provide enhanced risk stratification. Our aim was to validate the accuracy of SORT and SORT v2 in pancreatic cancer surgery.
Method: Two hundred and twelve patients were included and underwent pancreatic surgery for cancer. The surgeries were performed by a single surgical team in a single tertiary hospital (2016-2022). We assessed a total of four risk models: SORT, SORT v2, POSSUM (Physiology and Operative Severity Score for the enumeration of Mortality and Morbidity), and P-POSSUM (Portsmouth-POSSUM). The accuracy of the model was evaluated using an observed-to-expected (O:E) ratio and the area under the curve (AUC).
Results: The 30-day mortality rate was 3.3% (7 patients). Both SORT and SORT v2 demonstrated excellent discrimination traits (AUC: 0.98 and AUC: 0.98, respectively) and provided the best-performing calibration in the total analysis. However, both tools underestimated the 30-day mortality. Furthermore, both reported a high level of calibration and discrimination in the subgroup of patients undergoing pancreaticoduodenectomy, with previous ERCP, and CA19-9 ≥ 500 U/mL.
Conclusions: SORT and SORT v2 are efficient risk-assessment tools that should be adopted in the perioperative pathway, shared decision-making (SDM) process, and counseling of patients with pancreatic cancer undergoing surgery.
Databáze: MEDLINE
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