Cited 2 times since 2024 (3.3 per year) source: EuropePMC United European gastroenterology journal, Volume 12, Issue 10, 19 3 2024, Pages 1367-1377 T1 colorectal cancer patients' perspective on information provision and therapeutic decision-making after local resection. Dekkers N, Dang H, de Graaf M, Nobbenhuis K, Verhoeven DA, van der Kraan J, de Vos Tot Nederveen Cappel WH, Alkhalaf A, van Westreenen HL, Basiliya K, Peeters KCMJ, Westerterp M, Doornebosch PG, Hardwick JCH, Langers AMJ, Boonstra JJ
Background
Decision-making after local resection of T1 colorectal cancer (T1CRC) is often complex and calls for optimal information provision as well as active patient involvement.
Objective
The aim was to evaluate the perceptions of patients with T1CRC on information provision and therapeutic decision-making.
Methods
This multicenter cross-sectional study included patients who underwent endoscopic or local surgical resection as initial treatment. Information provision was assessed using the EORTC QLQ-INFO25 questionnaire. In patients with high-risk T1CRC, we evaluated decisional involvement and satisfaction regarding the choice as to whether to undergo additional treatment after local resection, and the level 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). Median time 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.
Conclusion
Greater attention should be given to the post-treatment course during consultations following local T1CRC resection. The differences in decisional involvement and selected management strategies between higher- and lower-educated high-risk patients warrant further investigation.
