P-POSSUM Falls Short: Predicting Morbidity in Ovarian Cancer (OC) Cytoreductive Surgery
Sometimes there are disappointments in the progress of treatment of ovarian cancer. One such is the realisation that predicting the outcome of surgery is more difficult than previously thought.
P-POSSUM (Physiologic and Operative Severity Score for the Study of Mortality and Morbidity) is a commonly used indicator of perioperative risk used for general surgery patients. Based on Age, Previous History of Disease and Blood Test, P-POSSUM has been shown to be a reasonable predictor of peri-operative morbidity and mortality.
This has led to a push for this to be used in the management of ovarian cancer seeking to avoid futile surgery for those most at risk. This retrospective study looked at data from 161 patients with ovarian cancer. Peri-operative morbidity occurred in 40% of these women. The predicted risk from the POSSUM score was higher at about 60%. Similarly, the score over-estimated the mortality. However, this may not be significant as the number of deaths occurring during the review period was small.
The authors suggest that POSSUM score is not applicable to ovarian cancer, other factors may need to be included when assessing risk.
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