| Title |
Where Oncologic and Surgical Complication Scoring Systems Collide: Time for a New Consensus for CRS/HIPEC
|
|---|---|
| Published in |
World Journal of Surgery, December 2015
|
| DOI | 10.1007/s00268-015-3366-0 |
| Pubmed ID | |
| Authors |
Kuno Lehmann, Dilmurodjon Eshmuminov, Ksenija Slankamenac, Benedict Kranzbühler, Pierre‐Alain Clavien, René Vonlanthen, Philippe Gertsch |
| Abstract |
Morbidity and mortality rates after cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) are important quality parameters to compare peritoneal surface malignancy centers. A major problem to assess postoperative outcomes among centers is the inconsistent reporting due to two coexisting systems, the diagnose-based common terminology criteria for adverse events (CTCAE) classification and the therapy-oriented Clavien-Dindo classification. We therefore assessed and compared both reporting systems. Complications after CRS/HIPEC were recorded in 147 consecutive patients and independently graded by an expert board using both systems. In a next step, a group of residents, experienced surgeons, and medical oncologists evaluated a set of twelve real complications, either with the Clavien-Dindo or CTCAE classification. The postoperative complication rate after CRS/HIPEC was 37 % (54/147), 6.8 % (10/147) were reoperated, and three (2 %) patients died. The most frequent complications were intestinal fistula or abscess, pulmonary complications, and ileus. Grading of complications with the CTCAE classification resulted in a significantly higher major morbidity rate compared to the Clavien-Dindo classification (25 vs. 8 %, p = 0.001). Evaluating a set of complications, residents, surgeons, and oncologists correctly assessed significantly more complications with the Clavien-Dindo compared to the CTCEA classification (p < 0.001). In addition, all participants evaluated the Clavien-Dindo classification as more simple. Residents (p < 0.001) and surgeons (p < 0.01) required less time with the Clavien-Dindo classification; there was no difference for oncologist. In conclusion, our data indicate that there is a different interpretation of severity grades of complications after CRS/HIPEC between the two classifications. There is a need for a common language in the field of CRS/HIPEC, which should be defined by a new consensus to compare surgical outcomes. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 50% |
| Science communicators (journalists, bloggers, editors) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 2% |
| Spain | 1 | 2% |
| Unknown | 41 | 95% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 8 | 19% |
| Student > Postgraduate | 6 | 14% |
| Student > Bachelor | 5 | 12% |
| Student > Master | 5 | 12% |
| Other | 4 | 9% |
| Other | 9 | 21% |
| Unknown | 6 | 14% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 22 | 51% |
| Social Sciences | 3 | 7% |
| Business, Management and Accounting | 2 | 5% |
| Nursing and Health Professions | 2 | 5% |
| Psychology | 2 | 5% |
| Other | 4 | 9% |
| Unknown | 8 | 19% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 October 2019.
All research outputs
#17,778,896
of 22,835,198 outputs
Outputs from World Journal of Surgery
#3,351
of 4,232 outputs
Outputs of similar age
#265,186
of 390,235 outputs
Outputs of similar age from World Journal of Surgery
#50
of 89 outputs
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