Evidence map›Paper›PMID 40507327›Full record

ArticleCancers2025

Machine Learning for Predicting the Low Risk of Postoperative Pancreatic Fistula After Pancreaticoduodenectomy: Toward a Dynamic and Personalized Postoperative Management Strategy.

Roberto Cammarata, Filippo Ruffini, Alberto Catamerò, Gennaro Melone, Gianluca Costa, Silvia Angeletti, Federico Seghetti, Vincenzo La Vaccara, Roberto Coppola, Paolo Soda and 2 more

Abstract read
In one paragraph

Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Roberto CammarataOperative Research Unit of General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Filippo RuffiniUnit of Computer Systems & Bioinformatics, Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.ORCID 0009-0003-9759-5492
Alberto CatameròUniversità Campus Bio-Medico di Roma, 00128 Rome, Italy.
Gennaro MeloneUniversità Campus Bio-Medico di Roma, 00128 Rome, Italy.ORCID 0009-0008-9289-3067
Gianluca CostaDepartment of Life Science, Health, and Health Professions, Link Campus University, 00165 Rome, Italy.ORCID 0000-0001-5194-8908
Silvia AngelettiUnit of Laboratory, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Federico SeghettiUniversità Campus Bio-Medico di Roma, 00128 Rome, Italy.
Vincenzo La VaccaraOperative Research Unit of General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Roberto CoppolaOperative Research Unit of General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Paolo SodaUnit of Computer Systems & Bioinformatics, Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.ORCID 0000-0003-2621-072X
Valerio GuarrasiUnit of Computer Systems & Bioinformatics, Department of Engineering, Università Campus Bio-Medico di Roma, 00128 Rome, Italy.ORCID 0000-0002-1860-7447
Damiano CaputoOperative Research Unit of General Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.ORCID 0000-0001-7058-1945

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative pancreatic fistula (POPF) remains one of the most relevant complications following pancreaticoduodenectomy (PD), significantly impacting short-term outcomes and delaying adjuvant therapies. Current predictive models offer limited accuracy, often failing to incorporate early postoperative data. This retrospective study aimed to develop and validate machine learning (ML) models to predict the absence and severity of POPF using clinical, surgical, and early postoperative variables.

methodsData from 216 patients undergoing PD were analyzed. A total of twenty-four machine learning (ML) algorithms were systematically evaluated using the Matthews Correlation Coefficient (MCC) and AUC-ROC metrics. Among these, the GradientBoostingClassifier consistently outperformed all other models, demonstrating the best predictive performance, particularly in identifying patients at low risk of postoperative pancreatic fistula (POPF) during the early postoperative period. To enhance transparency and interpretability, a SHAP (SHapley Additive exPlanations) analysis was applied, highlighting the key role of early postoperative biomarkers in the model predictions.

resultsThe performance of the GradientBoostingClassifier was also directly compared to that of a traditional logistic regression model, confirming the superior predictive performance over conventional approaches. This study demonstrates that ML can effectively stratify POPF risk, potentially supporting early drain removal and optimizing postoperative management.

conclusionsWhile the model showed promising performance in a single-center cohort, external validation across different surgical settings will be essential to confirm its generalizability and clinical utility. The integration of ML into clinical workflows may represent a step forward in delivering personalized and dynamic care after pancreatic surgery.

Indexed as

machine learning (ML)pancreatic ductal adenocarcinoma (PDAC)postoperative pancreatic fistula (POPF)

Identifiers

PMID40507327
PMCPMC12153646

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.