"Real-life" outcome of gastrointestinal tumor therapies: A single-center comparative study

BackgroundDespite of the ongoing improvements in gastrointestinal oncology, it remains unclear whether results of randomized controlled trials are achievable in daily clinical practice of nonacademic environments. AimThis study aims at assessing a potential efficacy-effectiveness gap in gastrointestinal cancer treatment. Methods and ResultsData from 656 gastrointestinal cancer patients treated between 2007 and 2015 in a medium-sized, nonacademic day hospital oncology unit in Italy were analyzed. Probability of survival and median overall survival as efficacy indicators and the occurrence of grades 3 to 4 adverse events as safety indicators were compared with randomized phase II/III trials of respective entities. Outcomes were well comparable between published data and the real-life setting. In resectable gastroesophageal cancer, 1-year survival after treatment initiation was greater (relative risks [RR] = 1.3, p = .007), while patients with adjuvant chemotherapy for pancreatic cancer exhibited inferior 2-year survival (RR = 0.7, p = .048) compared with referenced trials. At our unit, neutropenia was less frequent (5.8% vs 27.8%, p = .039) in palliative chemotherapy for pancreatic cancer, as was peripheral neuropathy for stage II/III colon cancer (3.9% vs 12.5%, p = .027). ConclusionThe "real-life" findings of this study support the efficacy and safety data achieved in landmark trials of gastrointestinal oncology.