Measurement of outcome

The outcomes of treatment of oesophageal cancer include traditional biological and physical measures, such as mortality and morbidity data, disease free and overall survival, clinical and pathological response rates and symptom control. Such factors are essential and should be recorded prospectively for clinical audit. Using this type of information alone to evaluate effectiveness of treatment is inadequate, however, because the diagnosis and treatment of oesophageal cancer has a major impact on functional wellbeing (including psycho-social function), general health perceptions and overall quality of life (QL)/satisfaction with health and health care. These aspects of patients' well-being need to be considered, in addition to standard outcomes in the evaluation of treatment of oesophageal cancer. Recent needs to judge the economic efficiency of health care by comparing health outcomes with costs may also be part of treatment appraisal. This article reviews surgical, oncological, patient-based and economic outcomes in oesophageal cancer. (C) 2002 Elsevier Science Ltd. All rights reserved.