Detailed Abstract
[BP Oral Presentation 2]
[BP OP 2-3] Clinical validation of scoring systems of postoperative pancreatic fistula after pancreatoduodenectomy : Applicability to Eastern cohorts?
Jae Seung KANG1, Taesung PARK2, Youngmin HAN1, Seungyeon LEE3, Jae Ri KIM1, Hongbeom KIM1, Wooil KWON1, Sun-Whe KIM1, Jin Seok HEO4, Dong Wook CHOI4, Song Cheol KIM5, Tae Ho HONG6, Dong Sup YOON7, Joon Seong PARK7, Sang Jae PARK8, Sung-Sik HAN8, Sae-Byeol
1Surgery and Cancer Research institute, Seoul National University College of Medicine, Korea
2Statistics and Interdisciplinary Program in Biostatistics, Seoul National University, Korea
3Mathematics and Statistics, Sejung University, Korea
4Surgery, Samsu
Introduction : Although several prediction models for the occurrence of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD) exist, all were established using Western cohorts. Large-scale external validation studies in Eastern cohorts that consider demographic variables including lower body mass index (BMI) are scarce. The purpose of this study was to externally validate POPF prediction models using nationwide large-scale Korean cohorts.
Methods : Nine tertiary university hospitals in the Republic of Korea participated. Patients’ preoperative characteristics, intraoperative factors, and pathologic findings were evaluated. POPF grades were determined according to the 2016 International Study Group on Pancreatic Surgery definition. Three POPF risk models (Callery, Roberts, and Mungroop) were selected for external validation.
Results : A total of 1898 PD patients were enrolled. A non-pancreatic disease diagnosis (hazard ratio [HR], 1.856; 95% confidence interval [CI], 1.223?2.817; P = 0.004), higher preoperative BMI (HR, 1.069; 95% CI, 1.019?1.121; P = 0.006), and soft pancreatic texture (HR, 1.859; 95% CI, 1.264?2.735; P = 0.002) were independent risk factors for clinically relevant POPF. The area under the receiver operating characteristic curve (AUC) values were 0.61, 0.64, and 0.63 on the Callery, Roberts, and Mungroop models, respectively; all were lower than those published in each external validation study.
Conclusions : Western POPF prediction models performed less well when applied to Korean cohorts. Thus, a large-scale Eastern-specific and externally validated POPF prediction model is needed.
Methods : Nine tertiary university hospitals in the Republic of Korea participated. Patients’ preoperative characteristics, intraoperative factors, and pathologic findings were evaluated. POPF grades were determined according to the 2016 International Study Group on Pancreatic Surgery definition. Three POPF risk models (Callery, Roberts, and Mungroop) were selected for external validation.
Results : A total of 1898 PD patients were enrolled. A non-pancreatic disease diagnosis (hazard ratio [HR], 1.856; 95% confidence interval [CI], 1.223?2.817; P = 0.004), higher preoperative BMI (HR, 1.069; 95% CI, 1.019?1.121; P = 0.006), and soft pancreatic texture (HR, 1.859; 95% CI, 1.264?2.735; P = 0.002) were independent risk factors for clinically relevant POPF. The area under the receiver operating characteristic curve (AUC) values were 0.61, 0.64, and 0.63 on the Callery, Roberts, and Mungroop models, respectively; all were lower than those published in each external validation study.
Conclusions : Western POPF prediction models performed less well when applied to Korean cohorts. Thus, a large-scale Eastern-specific and externally validated POPF prediction model is needed.
SESSION
BP Oral Presentation 2
Room D 4/5/2019 11:14 AM - 11:21 AM