Comparative effectiveness research: opportunities in surgical oncology

Area of Science:

• Surgical Oncology
• Comparative Effectiveness Research

Background:

• Randomized controlled trials (RCTs) in surgical oncology face challenges in feasibility, patient selection, generalizability, and timely results.
• A gap exists between efficacy studies (RCTs) and effectiveness research, which assesses real-world patient outcomes.

Purpose of the Study:

• To highlight the applicability and challenges of comparative effectiveness research (CER) in surgical oncology.
• To demonstrate how various CER methodologies can address surgical questions.

Main Methods:

• Review of past randomized trials and attempted trials in surgical oncology.
• Discussion of retrospective analyses and pragmatic trials as key CER methods.
• Examples of CER studies in prostate, breast, and rectal cancers.

Main Results:

• RCTs in surgical oncology often encounter significant feasibility and generalizability issues.
• CER methodologies offer valuable alternatives to assess treatment effectiveness in real-world settings.
• Ongoing initiatives are expanding the infrastructure for CER in surgical oncology.

Conclusions:

• Comparative effectiveness research is essential for advancing surgical oncology practice.
• Utilizing diverse CER methods is vital to overcome RCT limitations and inform clinical decisions.
• Continued development of CER infrastructure will enhance evidence generation in surgical oncology.