Validation of the Surgical Outcome Risk Tool (SORT) in patients with pancreatic cancer undergoing surgery

Magouliotis, Dimitrios; Samara, Athina; Fergadi, M.; Symeonidis, Dimitrios; Zacharoulis, Dimitris

doi:10.1016/j.bjane.2020.10.018

Cited by 1 publication

(3 citation statements)

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“…SORT and SORT v2 demonstrated the best-performing discrimination and calibration characteristics compared with all other risk-stratification models assessed in the present study. Our outcomes not only follow the preliminary outcomes of our previous study [ 12 ] but also highlight the superiority of both tools compared with POSSUM and P-POSSUM and validate SORT v2 for the first time. In this context, the outcomes of this study have direct implications for the SDM process of patients with PC regarding their postoperative mortality risk, thus helping patients to co-shape their treatment strategy.…”

Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

“…Our previous study implementing preliminary outcomes [ 12 ] was the first to validate SORT in patients undergoing surgery for pancreatic cancer, but we did not perform a comparison with other traditional risk-stratification tools. Furthermore, in that study [ 12 ], the number of included patients was limited. In addition, an updated version of SORT (SORT v2) has been developed that takes into consideration the physician’s risk estimation of the surgery [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

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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

Karamolegkou

Fergadi

Magouliotis

et al. 2023

JCM

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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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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%