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International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 1/2014

01-02-2014 | Original Article

Perioperative mortality and morbidity prediction using POSSUM, P-POSSUM and APACHE II in Chinese gastric cancer patients: surgical method is a key independent factor affecting prognosis

Authors: Yantian Fang, Chunhsien Wu, Xiaodong Gu, Zhengyang Li, Jianbin Xiang, Zongyou Chen

Published in: International Journal of Clinical Oncology | Issue 1/2014

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Abstract

Introduction

Gastric cancer is the fourth most common cancer worldwide. Predicting morbidity and mortality is important in deciding timing of surgery and type of surgery offered. APACHE II, POSSUM, and P-POSSUM are the most reliable scoring methods in use today. This is the first paper to evaluate the utility of all three scoring systems in China.

Methods

We collected data on 851 patients (583 male and 268 female) who underwent surgery between 1991 and 2011. Physiological and pathological data was entered in spreadsheet format and analyzed using STATA version 11.0 to generate ROC curves for each scoring system.

Results

In predicting mortality, P-POSSUM and POSSUM were most effective and APACHE II was ineffective. POSSUM predicted a higher morbidity risk than was actually encountered. Age and type of operation were found to be independent risk factors for mortality.

Discussion

The utility of the APACHE II score in gastric cancer patients is limited. APACHE II is suitable for considering group versus individual effect. The POSSUM score is useful in general surgery, but needs improvement. We found the P-POSSUM score to be superior for morbidity and mortality prediction. P-POSSUM is useful for both the general population and for a specific cohort. The type of surgery is a key decision point for surgeons, and independently affects prognosis. Based upon these findings and clinical scoring systems, clinicians can develop individualized treatment algorithms.
Literature
1.
Ferlay J, Shin HR, Bray F et al (2010) GLOBOCAN 2008 v2.0, cancer incidence and mortality worldwide: IARC CancerBase No. 10 [Internet]. International Agency for Research on Cancer, Lyon. http://​globocan.​iarc.​fr Accessed 4 Dec 2012
2.
Knaus WA, Draper EA, Wagner DP et al (1985) APACHE II: a severity of disease classification system. Crit Care Med 13:818–829PubMedCrossRef
3.
Copeland GP, Jones D, Walters M (1991) POSSUM: a scoring system for surgical audit. Br J Surg 78:355–360PubMedCrossRef
4.
Whiteley MS, Prytherch DR, Higgins B et al (1996) An evaluation of the POSSUM surgical scoring system. Br J Surg 83:812–815PubMedCrossRef
5.
Bennett-Guerrero E, Hyam JA, Shaefi S et al (2003) Comparison of P-POSSUM risk-adjusted mortality rates after surgery between patients in the USA and the UK. Br J Surg 90:1593–1598PubMedCrossRef
6.
Bosscha K, Reijnders K, Hulstaert PF et al (1997) Prognostic scoring systems to predict outcome in peritonitis and intra-abdominal sepsis. Br J Surg 84:1532–1534PubMedCrossRef
7.
Van Le L, Fakhry S, Walton LA et al (1995) Use of the APACHE II scoring system to determine mortality of gynecologic oncology patients in the intensive care unit. Obstet Gynecol 85:53–56PubMedCrossRef
8.
Ridley S (1998) Severity of illness scoring systems and performance appraisal. Anaesthesia 53:1185–1194PubMedCrossRef
9.
Ip SP, Leung YF, Ip CY et al (1999) Outcomes of critically ill elderly patients: is high-dependency care for geriatric patients worthwhile? Crit Care Med 27:2351–2357PubMedCrossRef
10.
11.
Hartley MN, Sagar PM (1994) The surgeon’s ‘gut feeling’ as a predictor of post-operative outcome. Ann R Coll Surg Engl 76:277–278PubMed
12.
Sah BK, Zhu ZG, Chen MM et al (2009) Effect of surgical work volume on postoperative complication: superiority of specialized center in gastric cancer treatment. Langenbecks Arch Surg 394:41–47PubMedCrossRef
13.
Mosquera D, Chiang N, Gibberd R (2008) Evaluation of surgical performance using V-POSSUM risk-adjusted mortality rates. ANZ J Surg 78:535–539PubMedCrossRef
14.
Tambyraja AL, Kumar S, Nixon SJ (2005) POSSUM scoring for laparoscopic cholecystectomy in the elderly. ANZ J Surg 75:550–552PubMedCrossRef
15.
Bennett-Guerrero E, Feierman DE, Barclay GR et al (2001) Preoperative and intraoperative predictors of postoperative morbidity, poor graft function, and early rejection in 190 patients undergoing liver transplantation. Arch Surg 136:1177–1183PubMedCrossRef
16.
Das N, Talaat AS, Naik R et al (2006) Risk adjusted surgical audit in gynaecological oncology: P-POSSUM does not predict outcome. Eur J Surg Oncol 32:1135–1138PubMedCrossRef
17.
Prytherch DR, Sutton GL, Boyle JR (2001) Portsmouth POSSUM models for abdominal aortic aneurysm surgery. Br J Surg 88:958–963PubMedCrossRef
18.
Jones DR, Copeland GP, de Cossart L (1992) Comparison of POSSUM with APACHE II for prediction of outcome from a surgical high-dependency unit. Br J Surg 79:1293–1296PubMedCrossRef
19.
de Cassia Braga Ribeiro K, Kowalski LP (2003) APACHE II, POSSUM, and ASA scores and the risk of perioperative complications in patients with oral or oropharyngeal cancer. Arch Otolaryngol Head Neck Surg 129:739–745PubMedCrossRef
Metadata
Title
Perioperative mortality and morbidity prediction using POSSUM, P-POSSUM and APACHE II in Chinese gastric cancer patients: surgical method is a key independent factor affecting prognosis
Authors
Yantian Fang
Chunhsien Wu
Xiaodong Gu
Zhengyang Li
Jianbin Xiang
Zongyou Chen
Publication date
01-02-2014
Publisher
Springer Japan
Published in
International Journal of Clinical Oncology / Issue 1/2014
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-013-0525-x

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