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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2011

01-10-2011 | Gastrointestinal Oncology

A Comparison of POSSUM and GPS Models in the Prediction of Post-operative Outcome in Patients Undergoing Oesophago-gastric Cancer Resection

Authors: Sumanta Dutta, MRCS, Nesrin M. Al-Mrabt, MSc, Grant M. Fullarton, MD, Paul G. Horgan, PhD, Donald C. McMillan, PhD

Published in: Annals of Surgical Oncology | Issue 10/2011

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Abstract

Background

There is some evidence that a patient’s pre-operative condition influences short-term and long-term post-operative outcomes. The aim of the present study is to compare the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and modified Glasgow prognostic score (mGPS) models in the prediction of post-operative outcome, both short term and long term, in patients undergoing resection of oesophago-gastric cancer.

Patients and Methods

Patients who underwent curative resection for oesophago-gastric cancer from January 2005 to May 2009 and who had data to score the POSSUM, P-POSSUM, O-POSSUM and mGPS models were included in the study. Observed morbidity and mortality rates were compared with predicted outcome in different risk groups. Both short-term outcome and long-term survival were recorded.

Results

Observed morbidity was 49%, whereas POSSUM predicted post-operative morbidity in 60%, giving an overall standardised morbidity ratio of 0.82. Only male sex [hazard ratio (HR) 3.61, 95% confidence interval (CI) 1.38–9.46, P = 0.009] and POSSUM physiology score (HR 2.13, 95% CI 1.11–4.08, P = 0.023) were independently associated with post-operative morbidity. The post-operative mortality rates predicted by POSSUM, P-POSSUM and O-POSSUM were 16.5, 5.8 and 9.9%, respectively, giving a standardised mortality ratio of 0.25, 0.71 and 0.42. Only mGPS (HR 1.96, 95% CI 1.09–3.54, P = 0.025) and tumour–node–metastasis (TNM) stage (HR 2.21, 95% CI 1.44–3.38, P < 0.001) were independently associated with cancer-specific survival.

Conclusions

The POSSUM physiology score was useful in predicting post-operative morbidity, and the mGPS was useful in predicting cancer-specific survival, in patients undergoing surgery for oesophago-gastric cancer.
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Metadata
Title
A Comparison of POSSUM and GPS Models in the Prediction of Post-operative Outcome in Patients Undergoing Oesophago-gastric Cancer Resection
Authors
Sumanta Dutta, MRCS
Nesrin M. Al-Mrabt, MSc
Grant M. Fullarton, MD
Paul G. Horgan, PhD
Donald C. McMillan, PhD
Publication date
01-10-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 10/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1676-5

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