Combined and intraoperative risk modelling for oesophagectomy: A systematic review

Table 5 Summary of the performance for each of the combined and intraoperative models

Predictive model (n)	Ref.	Discrimination	Calibration/other statistics	Outcome
POSSUM (5)	Zafirellis et al[36], 2002	0.55, 0.62	HL P < 0.001, 0.002	Morbidity + Mortality
	Lai et al[37], 2007	AUC = 0.776	O:E 0.367 (P = 0.001)	Mortality
	Filip et al[34], 2014	AUC = 0.826	O:E 1.11	Mortality
	Filip et al[32], 2015	AUC = 0.59	HL P value (0.08)	Morbidity
	Yamana et al[35], 2015	AUC = 0.601	Not reported	Resp complications
O-POSSUM (4)	Lai et al[37], 2007	AUC = 0.676	O:E 0.505 (P = 0.002)	Mortality
	Lagarde et al[38], 2007	AUC = 0.60	O:E 0.29 (P < 0.001)	Mortality
	Bosch et al[33], 2011	AUC = 0.756	HL P value (0.035)	Mortality
	Filip et al[34], 2014	AUC = 0.740	O:E 1.70	Mortality
P-POSSUM (3)	Lai et al[37], 2007	AUC = 0.776	O:E (P = 0.814)	Mortality
	Bosch et al[33], 2011	AUC = 0.766	HL P value (0.529)	Mortality
	Filip et al[34], 2014	AUC = 0.607	O:E 4.28	Mortality
E-PASS (3)	Baba et al[39], 2008	CRS > 1 (P < 0.001)	N/A	Morbidity
	Yoshida et al[40], 2013	CRS > 0.9 (P 0.029)	N/A	Morbidity
	Yamana et al[35], 2015	AUC = 0.659	N/A	Resp complications
Yoshida (1)	Yoshida et al[28], 2015	P value = < 0.001, 0.037	Not reported	Morbidity + Major morbidity
Xi SAS nomogram (1)	Xi et al[30], 2019	AUC = 0.903, 0.967	“Good”	Major morbidity
Xi IPF nomogram (1)	Xi et al[29], 2020	AUC = 0.921	“Sufficient”	Major morbidity
Huang (1)	Huang et al[31], 2020	AUC = 0.69	“Good”	Anastomotic leak
SAS (4)	Eto et al[42], 2016	AUC = 0.68	Cut off = 6 Pulm, SSI, AL	Major morbidity
	Stroyer et al[27], 2017	AUC = 0.561	All comp P = 0.148	Major morbidity
	Nakagawa et al[43], 2017	Not reported	Cut off > 5, P < 0.0001	Major morbidity
	Hayashi et al[45], 2019	Not reported	Cut off ≥ 6, P = 0.032	Major morbidity
eSAS (4)	Janowak et al[26], 2015	AUC = 0.614	Cut off = 6, Com P = 0.01	Major morbidity
	Xing et al[41], 2016	AUC = 0.62	Cut off > 7 LOS	Major morbidity
	Stroyer et al[27], 2017	AUC = 0.572	All comp P = 0.460	Major morbidity
	Aoki et al[44], 2019	Optimal cut-off 4 (Youden’s index = 0.069)	Major morbidity (P = 0.29)	Major morbidity
Modified eSAS (2)	Stroyer et al[27], 2017	AUC = 0.532	All comp P = 0.096	Major morbidity
	Aoki et al[44], 2019	Optimal cut-off 4 (Youden’s index = 0.180)	Major morbidity (P = 0.004)	Major morbidity

POSSUM: Physiological and operative severity score for the enumeration of mortality and morbidity; P-POSSUM: Portsmouth physiological and operative severity score for the enumeration of mortality and morbidity; O-POSSUM: Oesophagogastric physiological and operative severity score for the enumeration of mortality and morbidity; E-PASS: Estimation of physiologic ability and surgical stress; SAS: Surgical Apgar score; eSAS: Esophagectomy surgical Apgar score; N/A: Not applicable; IPF: Intraoperative factors; AUC: Area under the curve.