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Dekkers, N.; Dang, H.; Graaf, M. de; Nobbenhuis, K.; Verhoeven, D.A.; Kraan, J. van der; ... ; Boonstra, J.J. (2024)

T1 colorectal cancer patients' perspective on information provision and therapeutic decision-making after local resection

Article / Letter to editor
Background: Decision‐making after local resection of T1 colorectal cancer (T1CRC) isoften complex and calls for optimal information provision as well as active patientinvolvement.Objective: The aim was to evaluate the perceptions of patients with T1CRC oninformation provision and therapeutic decision‐making.Methods: This multicenter cross‐sectional study included patients who underwentendoscopic or local surgical resection as initial treatment. Information provision wasassessed using the EORTC QLQ‐INFO25 questionnaire. In patients with high‐riskT1CRC, we evaluated decisional involvement and satisfaction regarding thechoice as to whether to undergo additional treatment after local resection, and thelevel of decisional conflict using the Decisional Conflict Scale.Results: Ninety‐eight patients with T1CRC were included (72% response rate; 79/98 endoscopic and 19/98 local surgical resection; 45/98 high‐risk T1CRC). Mediantime since local resection was 28 months (IQR 18); none had...Show moreBackground: Decision‐making after local resection of T1 colorectal cancer (T1CRC) isoften complex and calls for optimal information provision as well as active patientinvolvement.Objective: The aim was to evaluate the perceptions of patients with T1CRC oninformation provision and therapeutic decision‐making.Methods: This multicenter cross‐sectional study included patients who underwentendoscopic or local surgical resection as initial treatment. Information provision wasassessed using the EORTC QLQ‐INFO25 questionnaire. In patients with high‐riskT1CRC, we evaluated decisional involvement and satisfaction regarding thechoice as to whether to undergo additional treatment after local resection, and thelevel of decisional conflict using the Decisional Conflict Scale.Results: Ninety‐eight patients with T1CRC were included (72% response rate; 79/98 endoscopic and 19/98 local surgical resection; 45/98 high‐risk T1CRC). Mediantime since local resection was 28 months (IQR 18); none had developed recurrence.Unmet information needs were reported by 29 patients (30%; 18 low‐risk, 11 high‐risk), mostly on post‐treatment related topics (follow‐up visits, recovery time,recurrence prevention). After local resection, 24 of the 45 high‐risk patients (53%)underwent additional treatment, while others were subjected to surveillance.Higher‐educated patients were more often actively involved in decision‐making(93% vs. 43%, p = 0.002) and more frequently underwent additional treatment(79% vs. 40%, p = 0.02). Decisional conflict (p = 0.19) and satisfaction (p = 0.78)were comparable between higher‐ and lower‐educated high‐risk patients.
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colorectal cancer
endoscopic resection
endoscopic submucosal dissection
local resection
All authors
Dekkers, N.; Dang, H.; Graaf, M. de; Nobbenhuis, K.; Verhoeven, D.A.; Kraan, J. van der; Cappel, W.H.D.T.N.; Alkhalaf, A.; Westreenen, H.L. van; Basiliya, K.; Peeters, K.C.M.J.; Westerterp, M.; Doornebosch, P.G.; Hardwick, J.C.H.; Langers, A.M.J.; Boonstra, J.J.
Date
2024-07-19
Journal
United European Gastroenterology Journal
DOI
doi:10.1002/ueg2.12628