A systematic review of clinical outcome reporting for curative surgical treatment of patients with pancreatic adenocarcinoma

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-02-20 DOI:10.1016/j.hpb.2025.02.008

Emily Britton , Matthew Kobetic , Eleanor McNally , Sarah Rudd , Shelley Potter , Robert Hinchliffe , Jonathan Rees

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引用次数: 0

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 to 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.

Conclusion

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.

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胰腺癌根治性手术治疗的临床结果系统回顾。

背景：胰腺癌是癌症相关死亡的主要原因。手术（配合全身治疗）提供了长期生存的唯一机会，但有很高的发病率和死亡率。来自荟萃分析的有力证据对决策至关重要，但由于研究之间的不一致而受到阻碍。本系统综述确定了评估治愈性胰腺癌手术的研究结果报告异质性的性质和程度。方法：检索Medline、Embase、Cochrane Central和clinicaltrials.gov网站2017 - 2023年的文献，纳入符合PROSPERO注册方案的随机和前瞻性研究。结果：纳入156项研究，共报告2088个结果，减少到399个独特的终点。所有研究均未报告单一结果。45%没有定义。不良事件和护理措施的提供（通常是手术的技术方面）分别占结果的60%和32%，而评估手术后身体功能的比例为6%。结论：使用结果的数量和多样性表明在选择和重要性领域的差异上缺乏洞察力。需要进一步开展工作，以嵌入统一的结果定义，协调数据收集，并将研究重点重新放在已证实相关的较少结果上。建议通过核心成果集就这些关键成果达成共识。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).