Research Article

Evaluation of P-Possum Scoring System in Patients Undergoing Colorectal Cancer Surgery

  • Haluk Recai Ünalp
  • Erdinç Kamer
  • Kemal Atahan
  • Fevzi Cengiz

Turk J Colorectal Dis 2007;17(2):71-75


The objectives of this study were to compare the observed mortality and morbidity rates in patients who underwent colorectal cancer surgery with those which were predicted using P-POSSUM scoring system and to determine whether this scoring system represented the observed surgical outcomes.


In this retrospective study, the mortality and morbidity risks of patients who underwent colorectal cancer surgery during the 5-year period between the years 2002 and 2006 were evaluated using P-POSSUM, and these results were compared with the outcomes observed in postoperative period. Postoperative morbidity which increases the residing times of patients in the hospital and mortality rates that occurred within postoperative 30 days was taken as a basis for evaluations of surgical outcomes.


Ninety patients who underwent colorectal cancer surgery and whose complete hospital records for our study design were collected were included in the study. The predicted mortality rate by P-POSSUM was 23%, whereas the observed mortality rate was 4.4% (p=0.000); and the predicted morbidity rate by P-POSSUM was 65.1%, whereas the observed morbidity rate was 58.9% (p=0.007).


P-POSSUM scoring system was found to be successful only in the prediction of morbidity rates in elective surgeries and in patients younger than 70 years of age. Our results showed that P-POSSUM scoring was an inadequate system in standardizing physiological and operative changes in colorectal cancer patients and could not be a useful tool for the prediction of mortality and morbidity which occurred during the postoperative period.

Keywords: P-POSSUM, Colon, Rectum, Cancer