(UroToday.com) The 2022 International Kidney Cancer Symposium (IKCS) European Annual meeting included an oral abstract session and presentation by Katharina Beyer discussing a systematic review of heterogeneity in outcome definition and reporting in localized kidney cancer. There is a need for core outcomes sets in kidney cancer research because outcomes are currently collected inconsistently with variability in reporting and measuring outcomes. This makes it difficult to compare and synthesize outcomes in order to (i) improve guidelines, (ii) better guide patients and clinicians during treatment decisions, and (iii) ultimately improve results in clinical practice. To minimize heterogeneity, an agreed minimum set of outcomes has been proposed as the appropriate solution. The following figures illustrate why there is a need for core outcome sets in kidney cancer research, specifically so that the same outcomes are being compared across trials:
versus
More specifically, this need has been highlighted by Ms. Beyer’s systematic review, which shows the heterogeneity of outcomes collected for localized kidney cancer. In their study, they systematically reviewed 2,785 studies (randomized clinical trials, cohort studies, case control studies, systematic reviews) and extracted outcomes of 152 studies. Outcomes were identified linked to death, adverse health outcomes, life impact, physiological/clinical, and resource utilization.
An example of outcomes from their systematic review which are linked to surgery is as follows:
- Operative time, which was heterogeneously measured as median, mean in either minutes or hours. One study defined operative time as ‘the incision of the skin to the end of the suture’
OR
- Warm ischemia time was measured either using the mean or median of minutes, less than 20, 25, or 30 minutes
Examples such as these make it very difficult to further synthesize the results for guideline development or benchmarking. Thus, standardizing and defining a list of outcome through the process of a core outcome set development will enable researchers to reach more meaningful clinical evidence. Core outcome sets are a consensus-derived collection of outcomes and instruments that allows researchers to measure a consistent set of clinical endpoints in studies of a health condition.
Katharina Beyer concluded her presentation discussing a systematic review of heterogeneity in outcome definition and reporting in localized kidney cancer with the following take-home messages:
- Patients, key stakeholders as the recipients of care, are not well served by the current evidence base on outcomes that reflect patient experience to inform decision making
- This systematic review shows that outcome reporting is characterized by disparate definitions and measurement heterogeneity in localized kidney cancer research
- Reporting, definition, and measurement heterogeneity makes evidence syntheses cumbersome and uninformative for guideline development
- A core outcomes set is the likely solution and is currently being developed for localized kidney cancer, much in the same way as has been developed in localized prostate cancer
Presented by: Katharina Beyer, BSc, MSc, Comprehensive Cancer Centre, King’s College London, London, United Kingdom
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Assistant Professor of Urology, Georgia Cancer Center, Augusta University/Medical College of Georgia, @zklaassen_md on Twitter during the 2022 International Kidney Cancer Symposium (IKCS) Europe Annual Hybrid Meeting, Antwerp, Belgium, Fri, Apr 22 – Sun, Apr 24, 2022.