Priorities, concerns, and regret among patients with head and neck cancer
| Autor: | Ana P. Kiess, Gypsyamber D'Souza, Wayne M. Koch, Karen T. Pitman, Melina J. Windon, Christine G. Gourin, Tanya Troy, Carole Fakhry, David W. Eisele, Farhoud Faraji |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Decision Making Logistic regression Article Odds Tumor Status Patient-Centered Care Internal medicine medicine Humans Prospective Studies Papillomaviridae Aged Aged 80 and over Health Priorities Squamous Cell Carcinoma of Head and Neck business.industry Papillomavirus Infections Head and neck cancer Age Factors Regret Odds ratio Middle Aged medicine.disease Survival Analysis Confidence interval Logistic Models Treatment Outcome Oncology Head and Neck Neoplasms Patient Satisfaction Spouse Female business |
| Zdroj: | Cancer. 125:1281-1289 |
| ISSN: | 1097-0142 0008-543X |
| Popis: | Background In the era of deintensification, little data are available regarding patients' treatment preferences. The current study evaluated treatment-related priorities, concerns, and regret among patients with head and neck squamous cell cancer (HNSCC). Methods A total of 150 patients with HNSCC ranked the importance of 10 nononcologic treatment goals relative to the oncologic goals of cure and survival. The level of concern regarding 11 issues and decision regret was recorded. Median rank was reported overall, and factors associated with odds of rank as a top 3 priority were modeled using logistic regression. Results Among the treatment effects analyzed, the odds of being a top 3 priority was especially high for cure (odds, 9.17; 95% confidence interval [95% CI], 5.05-16.63), followed by survival and swallow (odds, 1.26 [95% CI, 0.88-1.80] and odds, 0.85 [95% CI, 0.59-1.21], respectively). Prioritization of cure, survival, and swallow was similar based on human papillomavirus (HPV) tumor status. By increasing decade of age, older participants were found to be significantly less likely than younger individuals to prioritize survival (odds ratio, 0.72; 95% CI, 0.52-1.00). Concerns regarding mortality (P = .04) and transmission of HPV to the patient's spouse (P = .03) were more frequent among participants with HPV-associated HNSCC. Regret increased with additional treatment modalities (P = .02). Conclusions Patients with HNSCC overwhelming prioritize cure, followed by survival and swallow. The decreased prioritization of survival by older age supports further examination of treatment preference by age. The precedence of oncologic over nononcologic priorities among patients regardless of HPV tumor status supports the conservative adoption of deintensification regimens until the interplay between competing oncologic and nononcologic treatment goals is better understood. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text