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Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research.

ABSTRACT: In breast cancer studies, many different endpoints are used. Definitions are often not provided or vary between studies. For instance, "local recurrence" may include different components in similar studies. This limits transparency and comparability of results. This project aimed to reach consensus on the definitions of local event, second primary breast cancer, regional and distant event for breast cancer studies. The RAND-UCLA Appropriateness method (modified Delphi method) was used. A Consensus Group of international breast cancer experts was formed, including representatives of all involved clinical disciplines. Consensus was reached in two rounds of online questionnaires and one meeting. Twenty-four international breast cancer experts participated. Consensus was reached on 134 items in four categories. Local event is defined as any epithelial breast cancer or ductal carcinoma in situ (DCIS) in the ipsilateral breast, or skin and subcutaneous tissue on the ipsilateral thoracic wall. Second primary breast cancer is defined as epithelial breast cancer in the contralateral breast. Regional events are breast cancer in ipsilateral lymph nodes. A distant event is breast cancer in any other location. Therefore, this includes metastasis in contralateral lymph nodes and breast cancer involving the sternal bone. If feasible, tissue sampling of a first, solitary, lesion suspected for metastasis is highly recommended. This project resulted in consensus-based event definitions for classification of recurrence in breast cancer research. Future breast cancer research projects should adopt these definitions to increase transparency. This should facilitate comparison of results and conducting reviews as well as meta-analysis.

SUBMITTER: Moossdorff M

PROVIDER: S-EPMC4357796 | biostudies-literature | 2014 Dec

REPOSITORIES: biostudies-literature

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Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research.

Moossdorff Martine M van Roozendaal Lori M LM Strobbe Luc J A LJ Aebi Stefan S Cameron David A DA Dixon J Michael JM Giuliano Armando E AE Haffty Bruce G BG Hickey Brigid E BE Hudis Clifford A CA Klimberg V Suzanne VS Koczwara Bogda B Kühn Thorsten T Lippman Marc E ME Lucci Anthony A Piccart Martine M Smith Benjamin D BD Tjan-Heijnen Vivianne C G VC van de Velde Cornelis J H CJ Van Zee Kimberly J KJ Vermorken Jan B JB Viale Giuseppe G Voogd Adri C AC Wapnir Irene L IL White Julia R JR Smidt Marjolein L ML

Journal of the National Cancer Institute 20141107 12

<h4>Background</h4>In breast cancer studies, many different endpoints are used. Definitions are often not provided or vary between studies. For instance, "local recurrence" may include different components in similar studies. This limits transparency and comparability of results. This project aimed to reach consensus on the definitions of local event, second primary breast cancer, regional and distant event for breast cancer studies.<h4>Methods</h4>The RAND-UCLA Appropriateness method (modified ...[more]

PMID: 25381395

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Project description:BackgroundFear of cancer recurrence (FCR) is common amongst cancer survivors. There is rapidly growing research interest in FCR but a need to prioritize research to address the most pressing clinical issues and reduce duplication and fragmentation of effort. This study aimed to establish international consensus among clinical and academic FCR experts regarding priorities for FCR research.MethodsMembers of the International Psycho-oncology Society (IPOS) Fear of Cancer Recurrence Special Interest Group (FORwards) were invited to participate in an online Delphi study. Research domains identified in Round 1 were presented and discussed at a focus group (Round 2) to consolidate the domains and items prior to presentation in further survey rounds (Round 3) aimed at gaining consensus on research priorities of international significance.ResultsThirty four research items were identified in Round 1 and 33 of the items were consolidated into six overarching themes through a focus group discussion with FCR experts. The 33 research items were presented in subsequent rounds of the delphi technique. Twenty one participants contributed to delphi round 1, 16 in round 2, and 25 and 29 participants for subsequent delphi rounds. Consensus was reached for 27 items in round 3.1. A further four research items were identified by panelists and included in round 3.2. After round 3.2, 35 individual research items were ratified by the panelists. Given the high levels of consensus and stability between rounds, no further rounds were conducted. Overall intervention research was considered the most important focus for FCR research. Panelists identified models of care that facilitate greater access to FCR treatment and evaluation of the effectiveness of FCR interventions in real world settings as the two research items of highest priority. Defining the mechanisms of action and active components across FCR/P interventions was the third highest priority identified.ConclusionThe findings of this study outline a research agenda for international FCR research. Intervention research to identify models of care that increase access to treatment are based on a flexible approach based on symptom severity and can be delivered within routine clinical care were identified as research areas to prioritize. Greater understanding of the active components and mechanisms of action of existing FCR interventions will facilitate increased tailoring of interventions to meet patient need.

Dataset Information

Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research.

Publications

Maastricht Delphi consensus on event definitions for classification of recurrence in breast cancer research.

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