The Oncosurge strategy for the management of colorectal liver metastases – An external validation study

• Published in: European journal of surgical oncology 2008-05, Vol.34 (5), p.538-540
• Main Authors: O'Reilly, D.A, Chaudhari, M, Ballal, M, Ghaneh, P, Wu, A, Poston, G.J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Appropriateness criteria; Colorectal liver metastases; Colorectal Neoplasms - pathology; Colorectal Neoplasms - surgery; Commission on Professional and Hospital Activities; Decision Making; Decision Support Systems, Clinical - utilization; Female; Hematology, Oncology and Palliative Medicine; Humans; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Liver surgery; Male; Middle Aged; Multidisciplinary teams; OncoSurge; Patient Care Planning; Surgery; Therapy, Computer-Assisted
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2007.04.013

Abstract Introduction Because most patients with colorectal liver metastases (CRLM) present to general surgeons and oncologists without a specialist interest in their management, a computer program (OncoSurge) has been created that identifies individual patient resectability and recommends optimal treatment strategies. The aim of this study was to validate the Oncosurge strategy by comparing its recommendations with the decisions made by a multidisciplinary (MDT) meeting, in a supra-regional hepatobiliary referral centre, using real cases with known outcomes. Methods We reviewed the records and imaging of 98 consecutive patients with CRLM, who had been referred for decision making to our MDT meeting between January 1, 2004 and December 31, 2004. All patient and tumour characteristics were entered onto the Oncosurge decision model, which was accessed at www.evidis.com/oncosurge/ Results There was concordance between Oncosurge and MDT decisions in 93/98 cases. The observed kappa ( κ ) was 0.850 (95% CI: 0.728–0.972). In descriptive terms, a kappa score greater than 0.8 equates to “almost perfect agreement”. Conclusions Our results demonstrate the validity of the Oncosurge system when compared to one year of decision making in an established hepatobiliary MDT meeting. This confirms the utility of the Oncosurge system for decision making, audit and educational purposes.