Patients' treatment preferences for potentially resectable tumors of the head of the pancreas.
HPB (Oxford)
; 22(2): 265-274, 2020 02.
Article
em En
| MEDLINE
| ID: mdl-31501009
ABSTRACT
BACKGROUND:
The primary aim of this study was to assess if patients with potentially resectable ductal adenocarcinoma (PDAC) of the head of the pancreas would choose a Whipple procedure versus palliative chemotherapy.METHODS:
A cohort of adults with radiological resectable PDAC was enrolled at a tertiary Canadian teaching hospital. Participants were informed about treatment options, expected outcomes, and adverse events using data from the most recent scientific literature. Probability trade-off (PTO) was used to elicit treatment preferences.RESULTS:
Surgery was preferred by all participants except one (96.7% vs. 3.3%; P = 0.0001). For 90% of participants preferring surgery, the main reason was the hope of being cured (P = 0.001). If the risk of perioperative mortality was higher than 57%, the risk of perioperative morbidity higher than 85% and the survival benefit was less than 4 months, half of the participants preferred palliative chemotherapy. The likelihood of needing blood transfusions, the length of hospital stay, and long-term consequences such as diabetes or pancreatic exocrine insufficiency were negligible concerns to participants.CONCLUSIONS:
Informed patients with early-stage PDAC prefer resection over palliative chemotherapy. The dominating factor influencing their decision is the hope of a cure that overshadow the risks of complications, mortality and recurrent disease.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Neoplasias Pancreáticas
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Carcinoma Ductal Pancreático
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Preferência do Paciente
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
HPB (Oxford)
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2020
Tipo de documento:
Article