Systematic review and consensus definitions for standardised endpoints in perioperative medicine: postoperative cancer outcomes.
Abstract
The Standardising Endpoints for Perioperative Medicine group was established to derive
an appropriate set of endpoints for use in clinical trials related to anaesthesia
and perioperative medicine. Anaesthetic or analgesic technique during cancer surgery
with curative intent may influence the risk of recurrence or metastasis. However,
given the current equipoise in the existing literature, prospective, randomised, controlled
trials are necessary to test this hypothesis. As such, a cancer subgroup was formed
to derive endpoints related to research in onco-anaesthesia based on a current evidence
base, international consensus and expert guidance.We undertook a systematic review
to identify measures of oncological outcome used in the oncological, surgical, and
wider literature. A multiround Delphi consensus process that included up to 89 clinician-researchers
was then used to refine a recommended list of endpoints.We identified 90 studies in
a literature search, which were the basis for a preliminary list of nine outcome measures
and their definitions. A further two were added during the Delphi process. Response
rates for Delphi rounds one, two, and three were 88% (n=9), 82% (n=73), and 100% (n=10),
respectively. A final list of 10 defined endpoints was refined and developed, of which
six secured approval by ≥70% of the group: cancer health related quality of life,
days alive and out of hospital at 90 days, time to tumour progression, disease-free
survival, cancer-specific survival, and overall survival (and 5-yr overall survival).Standardised
endpoints in clinical outcomes studies will support benchmarking and pooling (meta-analysis)
of trials. It is therefore recommended that one or more of these consensus-derived
endpoints should be considered for inclusion in clinical trials evaluating a causal
effect of anaesthesia-analgesia technique on oncological outcomes.
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Journal articleSubject
StEP-COMPAC GroupPermalink
https://hdl.handle.net/10161/17268Published Version (Please cite this version)
10.1016/j.bja.2018.03.020Publication Info
Buggy, DJ; Freeman, J; Johnson, MZ; Leslie, K; Riedel, B; Sessler, DI; ... StEP-COMPAC
Group (2018). Systematic review and consensus definitions for standardised endpoints in perioperative
medicine: postoperative cancer outcomes. British journal of anaesthesia, 121(1). pp. 38-44. 10.1016/j.bja.2018.03.020. Retrieved from https://hdl.handle.net/10161/17268.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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