Patient Preferences for the Disclosure of Prognosis After Esophagectomy for Cancer with Curative Intent
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The aim of this study was to determine the preferences for content, style, and format of prognostic information of patients after potentially curative esophagectomy for cancer and to explore predictors of these preferences.
Patients and Methods
This multicenter study included a consecutive series of patients who underwent surgical resection for cancer in the past 2 years and who did not have evidence of cancer recurrence. A questionnaire was used to elicit patient preferences for the content, style, and format of prognostic information. Sociodemographic characteristics, clinicopathological factors, and quality of life (EORTC QLQ-30 and OES18) were explored as predictors for certain preferences.
Of the 204 eligible patients, 176 patients (86%) returned the questionnaire. The majority of patients desired prognostic information. Information preferences declined when information became more specific and more negative. Married patients and higher-educated patients were more likely to want all prognostic information. The majority of patients wanted their specialist to start the discussion about prognosis. However, a significant proportion of these patients wanted their specialist to first ask if they want to have prognostic information. The percentage of patients wanted a realistic and individualistic approach was 97%. Words and numbers were preferred over visual presentations.
After potentially curative esophagectomy for cancer, the majority of patients want detailed prognostic information and want their specialist to begin the prognostic discussion. Patients prefer their doctor to be realistic; words and numbers are preferred over figures and graphs.
KeywordsPrognosis Esophageal cancer Communication Esophagectomy Patient preferences
The authors are grateful to P. N. Butow for kindly allowing us to use their questionnaire and Anne Molenaar and Sue Braithwaite for translation of the questionnaire. Sjoerd M. Lagarde is supported by a grant (04-77) from the Maag Lever Darm Stichting (Dutch Digestive Diseases Foundation). Sanne J. Franssen is supported by a grant from the Dutch Cancer Society.
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