Retroperitoneal sarcoma perioperative risk stratification: A United States Sarcoma Collaborative evaluation of the ACS-NSQIP risk calculator

Patrick B. Schwartz, Christopher C. Stahl, Cecilia Ethun, Nicholas Marka, George A. Poultsides, Kevin K. Roggin, Ryan C. Fields, John H. Howard, Callisia N. Clarke, Konstantinos I. Votanopoulos, Kenneth Cardona, Daniel E. Abbott

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: The ACS-NSQIP risk calculator predicts perioperative risk. This study tested the calculator's ability to predict risk for outcomes following retroperitoneal sarcoma (RPS) resection. Methods: The United States Sarcoma Collaborative database was queried for adults who underwent RPS resection. Estimated risk for outcomes was calculated twice in the risk calculator, once using sarcoma-specific CPT codes and once using codes indicative of most comorbid organ resection (eg nephrectomy). ROC curves were generated, with area under the curve (AUC) and Brier scores reported to assess discrimination and calibration. An AUC < 0.6 was considered ineffective discrimination. A negative ▲ Brier indicated improved performance relative to baseline outcome rates. Results: In total, 482 patients were identified with a 42.3% 90-day complication rate. Discrimination was poor for all outcomes except “all complications” and “renal failure.” Baseline outcome rates were better predictors than calculator estimates except for “discharge to nursing or rehab facility” and “renal failure.” Replacing sarcoma-specific CPT codes with resection-specific codes did not improve performance. Conclusion: The ACS-NSQIP risk calculator poorly predicted outcomes following RPS resection. Changing sarcoma-specific CPT to resection-specific codes did not improve performance. Comorbidities in the calculator may not effectively capture perioperative risk. Future work should evaluate a sarcoma-specific calculator.

Original languageEnglish (US)
Pages (from-to)795-802
Number of pages8
JournalJournal of Surgical Oncology
Issue number4
StatePublished - Sep 1 2020
Externally publishedYes

Bibliographical note

Funding Information:
This study was supported by the he National Institutes of Health under Award Number T32 CA090217 and Award Number T32 ES007015. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2020 Wiley Periodicals LLC


  • brier
  • calibration
  • discrimination
  • outcomes
  • perioperative


Dive into the research topics of 'Retroperitoneal sarcoma perioperative risk stratification: A United States Sarcoma Collaborative evaluation of the ACS-NSQIP risk calculator'. Together they form a unique fingerprint.

Cite this