Reporting of outcomes in gastric cancer surgery trials: a systematic review

BACKGROUND: The development of clinical guidelines for the surgical management of gastric cancer should be based on robust evidence from well-designed trials. Being able to reliably compare and combine the outcomes of these trials is a key factor in this process. OBJECTIVES: To examine variation in outcome reporting by surgical trials for gastric cancer and to identify outcomes for prioritisation in an international consensus study to develop a core outcome set in this field. DATA SOURCES: Systematic literature searches (Evidence Based Medicine, MEDLINE, EMBASE, CINAHL, ClinicalTrials.gov and WHO ICTRP) and a review of study protocols of randomised controlled trials, published between 1996 and 2016. INTERVENTION: Therapeutic surgical interventions for gastric cancer. Outcomes were listed verbatim, categorised into groups (outcome themes) and examined for definitions and measurement instruments. RESULTS: Of 1919 abstracts screened, 32 trials (9073 participants) were identified. A total of 749 outcomes were reported of which 96 (13%) were accompanied by an attempted definition. No single outcome was reported by all trials. 'Adverse events' was the most frequently reported 'outcome theme' in which 240 unique terms were described. 12 trials (38%) classified complications according to severity, with 5 (16%) using a formal classification system (Clavien-Dindo or Accordion scale). Of 27 trials which described 'short-term' mortality, 15 (47%) used one of five different definitions. 6 out of the 32 trials (19%) described 'patient-reported outcomes'. CONCLUSION: Reporting of outcomes in gastric cancer surgery trials is inconsistent. A consensus approach to develop a minimum set of well-defined, standardised outcomes to be used by all future trials examining therapeutic surgical interventions for gastric cancer is needed. This should consider the views of all key stakeholders, including patients.

Contributors

Alkhaffaf, B. Blazeby, J. M. Williamson, P. R. Bruce, I. A. Glenny, A. M.

Publication

Journal: BMJ Open
Volume: 8
Issue: 10
Pages: e021796 -
Year: 2018
DOI: 10.1136/bmjopen-2018-02179

Further Study Information

Current Stage: Not Applicable
Date:
Funding source(s): This study was funded by the National Institute for Health Research (NIHR) Doctoral Research Fellowship Grant programme (DRF-2015-08-023).


Health Area

Disease Category: Cancer, Gastroenterology

Disease Name: Gastric Cancer

Target Population

Age Range: 18 - 100

Sex: Either

Nature of Intervention: Surgery

Stakeholders Involved

- None

Study Type

- Systematic review of outcomes measured in trials

Method(s)

- Systematic review