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

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 t...

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Autores principales: Karamolegkou, Anna P., Fergadi, Maria P., Magouliotis, Dimitrios E., Samara, Athina A., Tatsios, Evangelos, Xanthopoulos, Andrew, Pourzitaki, Chryssa, Walker, David, Zacharoulis, Dimitris
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058325/
https://www.ncbi.nlm.nih.gov/pubmed/36983326
http://dx.doi.org/10.3390/jcm12062327
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author Karamolegkou, Anna P.
Fergadi, Maria P.
Magouliotis, Dimitrios E.
Samara, Athina A.
Tatsios, Evangelos
Xanthopoulos, Andrew
Pourzitaki, Chryssa
Walker, David
Zacharoulis, Dimitris
author_facet Karamolegkou, Anna P.
Fergadi, Maria P.
Magouliotis, Dimitrios E.
Samara, Athina A.
Tatsios, Evangelos
Xanthopoulos, Andrew
Pourzitaki, Chryssa
Walker, David
Zacharoulis, Dimitris
author_sort Karamolegkou, Anna P.
collection PubMed
description 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.
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spelling pubmed-100583252023-03-30 Validation of the Surgical Outcome Risk Tool (SORT) and SORT v2 for Predicting Postoperative Mortality in Patients with Pancreatic Cancer Undergoing Surgery Karamolegkou, Anna P. Fergadi, Maria P. Magouliotis, Dimitrios E. Samara, Athina A. Tatsios, Evangelos Xanthopoulos, Andrew Pourzitaki, Chryssa Walker, David Zacharoulis, Dimitris J Clin Med Article 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. MDPI 2023-03-16 /pmc/articles/PMC10058325/ /pubmed/36983326 http://dx.doi.org/10.3390/jcm12062327 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Karamolegkou, Anna P.
Fergadi, Maria P.
Magouliotis, Dimitrios E.
Samara, Athina A.
Tatsios, Evangelos
Xanthopoulos, Andrew
Pourzitaki, Chryssa
Walker, David
Zacharoulis, Dimitris
Validation of the Surgical Outcome Risk Tool (SORT) and SORT v2 for Predicting Postoperative Mortality in Patients with Pancreatic Cancer Undergoing Surgery
title Validation of the Surgical Outcome Risk Tool (SORT) and SORT v2 for Predicting Postoperative Mortality in Patients with Pancreatic Cancer Undergoing Surgery
title_full Validation of the Surgical Outcome Risk Tool (SORT) and SORT v2 for Predicting Postoperative Mortality in Patients with Pancreatic Cancer Undergoing Surgery
title_fullStr Validation of the Surgical Outcome Risk Tool (SORT) and SORT v2 for Predicting Postoperative Mortality in Patients with Pancreatic Cancer Undergoing Surgery
title_full_unstemmed Validation of the Surgical Outcome Risk Tool (SORT) and SORT v2 for Predicting Postoperative Mortality in Patients with Pancreatic Cancer Undergoing Surgery
title_short Validation of the Surgical Outcome Risk Tool (SORT) and SORT v2 for Predicting Postoperative Mortality in Patients with Pancreatic Cancer Undergoing Surgery
title_sort validation of the surgical outcome risk tool (sort) and sort v2 for predicting postoperative mortality in patients with pancreatic cancer undergoing surgery
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10058325/
https://www.ncbi.nlm.nih.gov/pubmed/36983326
http://dx.doi.org/10.3390/jcm12062327
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