Using decision analysis to calculate the optimum treatment for microinvasive cervical cancer
| Autor: | P. Billingsley, S. E. Jones, N. Johnson, R. J. Lilford, L. McKenzie, F. F. Songane |
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| Rok vydání: | 1992 |
| Předmět: |
Adult
Cancer Research medicine.medical_specialty medicine.medical_treatment media_common.quotation_subject Uterine Cervical Neoplasms Fertility Hysterectomy Decision Theory Meta-Analysis as Topic Risk Factors medicine Humans Neoplasm Invasiveness Radical surgery media_common Cervical cancer business.industry Decision Trees Surgical mortality Cancer Patient Acceptance of Health Care Prognosis medicine.disease Surgery Oncology Carcinoma Squamous Cell Female Risk of death business Infertility Female Research Article Decision analysis |
| Zdroj: | British Journal of Cancer |
| ISSN: | 1532-1827 0007-0920 |
| DOI: | 10.1038/bjc.1992.151 |
| Popis: | Decision theory was used to calculate the optimum treatment of microscopic squamous cervical cancer using probabilities obtained from an exhaustive literature review and a range of plausible value estimates. This showed that if there is no vascular involvement, survival is maximised by conservative treatment if tumour invasion is less than 3 mm while treatment by radical surgery results in maximal survival rates if the tumour invasion is over 3 mm. Radical surgery also maximises survival for smaller lesions where lymph channel involvement is present, especially if a surgical mortality at the lower end of the reported range is assumed. Refinement of our analysis to include an assessment of patient values showed that these conclusions are still valid regardless of the patient's relative preference for death from surgery or death from cancer. However, the wish to preserve fertility sharply reduces the overall net benefit of surgery. Conservative treatment becomes the preferred option for all microinvasive lesions even for patients who are prepared to trade-off a small (e.g. 2%) risk of death in order to retain their fertility. |
| Databáze: | OpenAIRE |
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