Reliable Cancer Therapies

Location: Belgium
Collaboration: Belgian Cancer Registry & BIG Pelvien group of the Vlaamse Werkgroep Oncologische Gynaecologie (Flemish Working Group for Oncological Gynaecology)

EFFECT is a project aiming to compare the effectiveness of the various therapeutic strategies in the management of endometrial cancer in Belgium. It is a collaborative project between the BIG Pelvien group of the Vlaamse Werkgroep Oncologische Gynaecologie (Flemish Working Group for Oncological Gynaecology), the Belgian Cancer Registry and Reliable Cancer Therapies.

EFFECT aims to evaluate effectiveness which is different from efficacy. Efficacy can be defined as the extent to which an intervention does more good than harm under ideal circumstances (i.e., in circumstances designed to maximize the effect of the intervention and eliminate confounding factors). Efficacy is assessed in randomized clinical trials on a stringently selected group of patients. Effectiveness can be defined as the extent to which an intervention does more good than harm when provided to real-world patients by physicians practicing in ordinary clinical settings. Effectiveness is assessed by observational studies.

Many relevant clinical questions have not been addressed in clinical trials or no definitive answer can be drawn from the available trials. The complexity, cost, logistics and design of clinical trials limit the possibility of addressing some questions.

Nowadays, the evidence for endometrial cancer management is not sufficient to fully decide what the best treatment options are according to the stage of the cancer. This does not mean that today’s management of patients is not satisfactory but it means that it is sometimes difficult for doctors and their patients to decide what the best option is. The main points of incertitude concern the most effective adjuvant therapies according to the stage and type of cancer, and the impact of complete removal of the lymph nodes on rates of survival.

With the help of an extensive and prospective data collection in several Belgian centers on all aspects of the management of endometrial treatments, the goal of our study is to compare the different strategies performed in those centers and identify the most effective ones.
In parallel, definition and collection of quality indicators for the management of endometrial cancers will be done to identify the variability of practice in the different participating centers. Quality indicators are measured to assess the quality of the treatment and care. The dissemination of the results of quality indicators to each participating center will allow them to take measures to improve the quality of care.