OUTCOME ASSESSMENT IN CANCER MANAGEMENT - 06/09/11

Doi : 10.1016/S0039-6109(05)70196-1

Marcello Tamburini, PhD ^a, Paolo G. Casali, MD ^b, Guido Miccinesi, MD ^c
^a Units of Psychology (MT)
^b Medical Oncology A (PGC), Istituto Nazionale Tumori, Milan
^c Unit of Epidemiology, Center for Study and Prevention of Cancer, A. O. Careggi, Florence (GM), Italy

Résumé

The goals of cancer treatment may be prevention, cure, or palliation. In each case, the length and the quality of survival are the ultimate outcomes to assess when evaluating the success of treatment. Some surrogate or intermediate endpoints, however, may be considered, such as the toxicity or the tumor response.

The first section of this article considers traditional outcomes and endpoints, mainly represented by survival and intermediate or surrogate endpoints for survival and quality of life. The second section specifically addresses the issue of the quality-of-life outcome, which has become increasingly important over the last 2 decades. The last section suggests that combining survival and quality of life may not be easy.

Costs are more important in management of diseases, and the outcomes of cancer treatment always may be weighed against them. The definitions of cost-effectiveness and cost-utility are mentioned at the end of this article, although the article does not deal with the problems of decision making for health resource allocation.

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