OBJECTIVE:
Scoring systems was developed to predict outcomes after surgical operation for colorectal cancers. Our aim was to compared POSSUM, P-POSSUM, CR-POSSUM and ACPGBI-CRC scoring systems to detirmine which one is the most predictive factor for mortality in patients undergoing colorectal cancer surgery.
METHODS:
One hundred thirty patients with colorectal cancer surgery operated at Dicle University Medical Faculty General Surgical clinic between January 2002 and July 2007 were included in this study. Receiver Operator Characteristic (ROC) curve analyz and Hosmer-Lemeshow test were used to determine accuracy of postoperative mortality for POSSUM, P-POSSUM, CR-POSSUM and ACPGBICRC scoring systems.
RESULTS:
Mortality rate was 17(13%) among 130 patients. POSSUM, P-POSSUM, CR-POSSUM, and ACPGBICRC were obtained as 6.15 (p=0.0925), 5.38 (p=0.0538), 9.23 (p=0.4315), and 9.23 (p=0.4315) respectively for predicting the expected and observed mortality ratios when Hosmer-Lemeshow test was used. In the Receiver Operator Characteristic (ROC) curve analysis, which was done for determining the accuracy of scoring tests, AUC value of ACPGBI-CRC (%95CI) was compared with the AUC values of the other scoring tests and following AUC values were found as: CR-POSSUM 0.969 (p=0.270), P-POSSUM 0.959 (p=0.232), and POSSUM 0.949 (p=0.167).
CONCLUSION:
We think that CR- POSSUM and ACPGBICRC scoring systems are more sensitive than the others in prediction of mortality ratio for patients, operated due to colorectal cancer.
Keywords: Colorectal Cancer, Mortality, Scoring Systems