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Patients' and gynecologists' views on sentinel lymph node mapping in low- and intermediate-risk endometrial cancer: a Dutch vignette study.
Aarts, Johanna W M; Burg, Lara C; Kasius, Jenneke C; Groenewoud, Hans; Kraayenbrink, Arjan A; Stalmeier, Peep; Zusterzeel, Petra L M.
Afiliación
  • Aarts JWM; Obstetrics and Gynecology, Radboudumc, Nijmegen, The Netherlands j.w.m.aarts@gmail.com.
  • Burg LC; Obstetrics and Gynecology, Radboudumc, Nijmegen, The Netherlands.
  • Kasius JC; Department of Gynaecology, Amsterdam University Medical Centre, location AMC, Amsterdam, The Netherlands.
  • Groenewoud H; Health Evidence, Radboudumc University Medical Center, Nijmegen, The Netherlands.
  • Kraayenbrink AA; Obstetrics & Gynaecology, Rijnstate Hospital, Arnhem, The Netherlands.
  • Stalmeier P; Health Evidence, Radboudumc University Medical Center, Nijmegen, The Netherlands.
  • Zusterzeel PLM; Obstetrics and Gynecology, Radboudumc, Nijmegen, The Netherlands.
Int J Gynecol Cancer ; 30(6): 813-818, 2020 06.
Article en En | MEDLINE | ID: mdl-32385051
OBJECTIVE: Sentinel lymph node (SLN) mapping in endometrial cancer is gaining ground. However, patient views on this new technique are unknown. The aim of this study was to determine factors important to patients and gynecologists when considering SLN mapping in low- and intermediate-risk endometrial cancer. METHODS: We performed a vignette study. Patients who underwent a total hysterectomy for low- or intermediate-risk endometrial cancer between 2012 and 2015 were invited. Dutch gynecologists specializing in gynecologic oncology were also invited. We based the selection for attributes in the vignettes on literature and interviews: risk of complications of SLN mapping; chance of finding a metastasis; survival gain; risk of complications after radiotherapy; operation time; and hospital of surgery (travel time). We developed a questionnaire with 18 hypothetical scenarios. Each attribute level varied and for each scenario, participants were asked how strongly they would prefer SLN on a scale from 1 to 7. The strength of preference for each scenario was analyzed using linear mixed effects models. RESULTS: A total of 38% of patients (41/108) and 33% of gynecologists (42/126) participated in the study. Overall, they had a preference for SLN. The mean preference for patients was 4.29 (95% CI 3.72 to 4.85) and 4.39 (95% CI 3.99 to 4.78) for gynecologists. Patients' preferences increased from 3.4 in the case of no survival gain to 4.9 in the case of 3-year survival gain (P<0.05) and it decreased when travel time increased to >60 min (-0.4, P=0.024), or with an increased risk of complications after adjuvant radiotherapy (-0.6, P=0.002). For gynecologists all attributes except travel time were important. CONCLUSIONS: Overall, patients and gynecologists were in favor of SLN mapping in low- and intermediate-risk endometrial cancer. Most important to patients were survival gain, travel time, and complication risk after adjuvant radiotherapy. These preferences should be taken into account when counseling about SLN mapping.
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Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Endometriales / Biopsia del Ganglio Linfático Centinela / Prioridad del Paciente Tipo de estudio: Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Gynecol Cancer Asunto de la revista: GINECOLOGIA / NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Países Bajos

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Endometriales / Biopsia del Ganglio Linfático Centinela / Prioridad del Paciente Tipo de estudio: Etiology_studies / Prognostic_studies / Qualitative_research / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Int J Gynecol Cancer Asunto de la revista: GINECOLOGIA / NEOPLASIAS Año: 2020 Tipo del documento: Article País de afiliación: Países Bajos