Abstract
Background
Pancreatic cancer is a leading cause of cancer-related death. Surgery (with systemic therapy) provides the only chance for long-term survival, but carries a high risk of morbidity and mortality. Robust evidence from meta-analyses, essential in informing decisions, is thwarted by inconsistencies between studies. This systematic review determines the nature and degree of heterogenous outcome reporting in research evaluating curative pancreatic cancer surgery.
Methods
A literature search of Medline, Embase, Cochrane Central and clinicaltrials.gov from 2017-2023 for eligible randomised and prospective studies adhering to a PROSPERO registered protocol.
Results
Included were 156 studies reporting a total of 2088 outcomes which deduplicated to 399 unique endpoints. No single outcome was reported in all studies. 45% were not defined. Adverse events and delivery of care measures (typically technical aspects of surgery) accounted for 60% and 32% of outcomes respectively, compared to 6% evaluating physical functioning post-surgery.
Discussion
The vast number and diversity of outcomes in use demonstrates lack of discernment in choice and disparity over domains of importance. Further work is needed to embed uniform outcome definitions, harmonise data collection and refocus research on fewer outcomes of proven relevance. Developing consensus on these critical outcomes through a Core Outcome Set is recommended.
Pancreatic cancer is a leading cause of cancer-related death. Surgery (with systemic therapy) provides the only chance for long-term survival, but carries a high risk of morbidity and mortality. Robust evidence from meta-analyses, essential in informing decisions, is thwarted by inconsistencies between studies. This systematic review determines the nature and degree of heterogenous outcome reporting in research evaluating curative pancreatic cancer surgery.
Methods
A literature search of Medline, Embase, Cochrane Central and clinicaltrials.gov from 2017-2023 for eligible randomised and prospective studies adhering to a PROSPERO registered protocol.
Results
Included were 156 studies reporting a total of 2088 outcomes which deduplicated to 399 unique endpoints. No single outcome was reported in all studies. 45% were not defined. Adverse events and delivery of care measures (typically technical aspects of surgery) accounted for 60% and 32% of outcomes respectively, compared to 6% evaluating physical functioning post-surgery.
Discussion
The vast number and diversity of outcomes in use demonstrates lack of discernment in choice and disparity over domains of importance. Further work is needed to embed uniform outcome definitions, harmonise data collection and refocus research on fewer outcomes of proven relevance. Developing consensus on these critical outcomes through a Core Outcome Set is recommended.
| Original language | English |
|---|---|
| Journal | HPB |
| Early online date | 20 Feb 2025 |
| DOIs | |
| Publication status | E-pub ahead of print - 20 Feb 2025 |
Bibliographical note
Publisher Copyright:© 2025 The Authors
