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Erschienen in: Annals of Surgical Oncology 1/2006

01.01.2006 | Original Article

Method of Presenting Oncology Treatment Outcomes Influences Patient Treatment Decision-Making in Metastatic Colorectal Cancer

verfasst von: Robert C. G. Martin II, MD, Sheri A. McGuffin, MAE, Lynne M. Roetzer, BA, Troy D. Abell, PhD, MPH, Jamie L. Studts, PhD

Erschienen in: Annals of Surgical Oncology | Ausgabe 1/2006

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Abstract

Background

The methods used to communicate relevant outcomes in oncology to patients will likely influence treatment decisions. The purpose of this study was to examine the influence of three different methods of describing the efficacy of therapy on treatment decisions regarding management of metastatic colorectal cancer.

Methods

Participants reviewed a clinical scenario and randomly received one of three ways of describing efficacy of chemotherapy in metastatic colorectal cancer: (1) relative risk reduction, (2) tumor response rate, and (3) median overall survival. They received the same clinical scenario but were presented four treatment options: (1) observation and supportive care, (2) chemotherapy, (3) surgery, and (4) surgery and chemotherapy and the accompanying median overall survival estimate.

Results

Participants included 102 preclinical medical students. In the first scenario, 85% chose chemotherapy in the relative risk reduction group, as did 88% of the tumor response rate group, but significantly fewer participants did so in the median overall survival group (35%; P < .001). In the second scenario, there was a significant difference in treatment preferences, with 4% of participants choosing observation/supportive care. None chose chemotherapy only, 19% chose surgery only, and 77% chose surgery plus chemotherapy (P < .001).

Conclusions

This study demonstrated that different methods of describing oncology treatment outcomes associated with therapy for metastatic colorectal cancer to the liver can have a dramatic effect on patient treatment decisions.
Literatur
1.
Zurück zum Zitat Ramsey SD, Mandelson MT, Berry K, Etzioni R, Harrison R. Cancer-attributable costs of diagnosis and care for persons with screen-detected versus symptom-detected colorectal cancer. Gastroenterology 2003;125:1645–50CrossRef Ramsey SD, Mandelson MT, Berry K, Etzioni R, Harrison R. Cancer-attributable costs of diagnosis and care for persons with screen-detected versus symptom-detected colorectal cancer. Gastroenterology 2003;125:1645–50CrossRef
2.
Zurück zum Zitat Fong Y, Cohen AM, Fortner JG, et al. Liver resection for colorectal metastases. J Clin Oncol 1997;15:938–46CrossRef Fong Y, Cohen AM, Fortner JG, et al. Liver resection for colorectal metastases. J Clin Oncol 1997;15:938–46CrossRef
3.
Zurück zum Zitat Rothman AJ, Kiviniemi MT. Treating people with information: an analysis and review of approaches to communicating health risk information. J Natl Cancer Inst Monogr 1999;25:44–51CrossRef Rothman AJ, Kiviniemi MT. Treating people with information: an analysis and review of approaches to communicating health risk information. J Natl Cancer Inst Monogr 1999;25:44–51CrossRef
4.
Zurück zum Zitat Saltz LB, Cox JV, Blanke C, et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 2000;343:905–14CrossRef Saltz LB, Cox JV, Blanke C, et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 2000;343:905–14CrossRef
5.
Zurück zum Zitat Maindrault-Goebel F, Louvet C, Andre T, et al. Oxaliplatin added to the simplified bimonthly leucovorin and 5-fluorouracil regimen as second-line therapy for metastatic colorectal cancer (FOLFOX6). GERCOR. Eur J Cancer 1999;35:1338–42CrossRef Maindrault-Goebel F, Louvet C, Andre T, et al. Oxaliplatin added to the simplified bimonthly leucovorin and 5-fluorouracil regimen as second-line therapy for metastatic colorectal cancer (FOLFOX6). GERCOR. Eur J Cancer 1999;35:1338–42CrossRef
6.
Zurück zum Zitat Engstrom PF, Saltz LB. Update: colorectal cancer guidelines. J Natl Compr Cancer Network 2003;1:9–16 Engstrom PF, Saltz LB. Update: colorectal cancer guidelines. J Natl Compr Cancer Network 2003;1:9–16
7.
Zurück zum Zitat Bilchik AJ, Wood TF, Allegra D, et al. Cryosurgical ablation and radiofrequency ablation for unresectable hepatic malignant neoplasms: a proposed algorithm. Arch Surg 2000;135:657–62CrossRef Bilchik AJ, Wood TF, Allegra D, et al. Cryosurgical ablation and radiofrequency ablation for unresectable hepatic malignant neoplasms: a proposed algorithm. Arch Surg 2000;135:657–62CrossRef
8.
Zurück zum Zitat Weber SM, Jarnagin WR, DeMatteo RP, Blumgart LH, Fong Y. Survival after resection of multiple hepatic colorectal metastases. Ann Surg Oncol 2000;7:643–50CrossRef Weber SM, Jarnagin WR, DeMatteo RP, Blumgart LH, Fong Y. Survival after resection of multiple hepatic colorectal metastases. Ann Surg Oncol 2000;7:643–50CrossRef
9.
Zurück zum Zitat Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 1999;230:309–18CrossRef Fong Y, Fortner J, Sun RL, Brennan MF, Blumgart LH. Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer: analysis of 1001 consecutive cases. Ann Surg 1999;230:309–18CrossRef
10.
Zurück zum Zitat Bremnes RM, Andersen K, Wist EA. Cancer patients, doctors, nurses vary in their willingness to undertake cancer chemotherapy. Eur J Cancer 1995;31A:1955–9CrossRef Bremnes RM, Andersen K, Wist EA. Cancer patients, doctors, nurses vary in their willingness to undertake cancer chemotherapy. Eur J Cancer 1995;31A:1955–9CrossRef
11.
Zurück zum Zitat Bremnes RM. Experience with and attitudes to chemotherapy among newly employed nurses in oncological and surgical departments: a longitudinal study. Support Care Cancer 1999;7:11–6CrossRef Bremnes RM. Experience with and attitudes to chemotherapy among newly employed nurses in oncological and surgical departments: a longitudinal study. Support Care Cancer 1999;7:11–6CrossRef
12.
Zurück zum Zitat Jansen SJ, Kievit J, Nooij MA, Stiggelbout AM. Stability of patients’ preferences for chemotherapy: the impact of experience. Med Decis Making 2001;21:295–306CrossRef Jansen SJ, Kievit J, Nooij MA, Stiggelbout AM. Stability of patients’ preferences for chemotherapy: the impact of experience. Med Decis Making 2001;21:295–306CrossRef
13.
Zurück zum Zitat Jansen SJ, Kievit J, Nooij MA, et al. Patients’ preferences for adjuvant chemotherapy in early-stage breast cancer: is treatment worthwhile? Br J Cancer 2001;84:1577–85CrossRef Jansen SJ, Kievit J, Nooij MA, et al. Patients’ preferences for adjuvant chemotherapy in early-stage breast cancer: is treatment worthwhile? Br J Cancer 2001;84:1577–85CrossRef
14.
Zurück zum Zitat McQuellon RP, Muss HB, Hoffman SL, Russell G, Craven B, Yellen SB. Patient preferences for treatment of metastatic breast cancer: a study of women with early-stage breast cancer. J Clin Oncol 1995;13:858–68CrossRef McQuellon RP, Muss HB, Hoffman SL, Russell G, Craven B, Yellen SB. Patient preferences for treatment of metastatic breast cancer: a study of women with early-stage breast cancer. J Clin Oncol 1995;13:858–68CrossRef
15.
Zurück zum Zitat Slevin ML, Stubbs L, Plant HJ, et al. Attitudes to chemotherapy: comparing views of patients with cancer with those of doctors, nurses, and general public. BMJ 1990;300:1458–60CrossRef Slevin ML, Stubbs L, Plant HJ, et al. Attitudes to chemotherapy: comparing views of patients with cancer with those of doctors, nurses, and general public. BMJ 1990;300:1458–60CrossRef
16.
Zurück zum Zitat Piga A, Graziano F, Zahra G, Cellerino R. Attitudes of non-oncology physicians dealing with cancer patients. A survey based on clinical scenarios in Ancona province, central Italy. Tumori 1996;82:423–9CrossRef Piga A, Graziano F, Zahra G, Cellerino R. Attitudes of non-oncology physicians dealing with cancer patients. A survey based on clinical scenarios in Ancona province, central Italy. Tumori 1996;82:423–9CrossRef
17.
Zurück zum Zitat Elger BS, Harding TW. Should cancer patients be informed about their diagnosis and prognosis? Future doctors and lawyers differ. J Med Ethics 2002;28:258–65CrossRef Elger BS, Harding TW. Should cancer patients be informed about their diagnosis and prognosis? Future doctors and lawyers differ. J Med Ethics 2002;28:258–65CrossRef
18.
Zurück zum Zitat Rodriguez-Marin J, Lopez-Roig S, Pastor MA. Doctors’ decision-making on giving information to cancer patients. Psychol Health 1996;11:839–44CrossRef Rodriguez-Marin J, Lopez-Roig S, Pastor MA. Doctors’ decision-making on giving information to cancer patients. Psychol Health 1996;11:839–44CrossRef
19.
Zurück zum Zitat Chao C, Studts JL, Abell T, et al. Adjuvant chemotherapy for breast cancer: how presentation of recurrence risk influences decision-making. J Clin Oncol 2003;21:4299–305CrossRef Chao C, Studts JL, Abell T, et al. Adjuvant chemotherapy for breast cancer: how presentation of recurrence risk influences decision-making. J Clin Oncol 2003;21:4299–305CrossRef
20.
Zurück zum Zitat Cunningham D, Pyrhonen S, James RD, et al. Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer. Lancet 1998;352:1413–8CrossRef Cunningham D, Pyrhonen S, James RD, et al. Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer. Lancet 1998;352:1413–8CrossRef
21.
Zurück zum Zitat Nordlinger B, Guiguet M, Vaillant JC, et al. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer 1996;77:1254–62CrossRef Nordlinger B, Guiguet M, Vaillant JC, et al. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer 1996;77:1254–62CrossRef
22.
Zurück zum Zitat Rougier P, Milan C, Lazorthes F, et al. Prospective study of prognostic factors in patients with unresected hepatic metastases from colorectal cancer. Fondation Francaise de Cancerologie Digestive. Br J Surg 1995;82:1397–400CrossRef Rougier P, Milan C, Lazorthes F, et al. Prospective study of prognostic factors in patients with unresected hepatic metastases from colorectal cancer. Fondation Francaise de Cancerologie Digestive. Br J Surg 1995;82:1397–400CrossRef
23.
Zurück zum Zitat Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg 1995;19:59–71CrossRef Scheele J, Stang R, Altendorf-Hofmann A, Paul M. Resection of colorectal liver metastases. World J Surg 1995;19:59–71CrossRef
24.
Zurück zum Zitat Scheele J, Stangl R, Altendorf-Hofmann A, Gall FP. Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 1991;110:13–29PubMed Scheele J, Stangl R, Altendorf-Hofmann A, Gall FP. Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 1991;110:13–29PubMed
25.
Zurück zum Zitat Rougier P, Milan C, Lazorthes F, et al. Prospective study of prognostic factors in patients with unresected hepatic metastases from colorectal cancer. Fondation Francaise de Cancerologie Digestive. Br J Surg 1995;82:1397–400CrossRef Rougier P, Milan C, Lazorthes F, et al. Prospective study of prognostic factors in patients with unresected hepatic metastases from colorectal cancer. Fondation Francaise de Cancerologie Digestive. Br J Surg 1995;82:1397–400CrossRef
26.
Zurück zum Zitat Cunningham D, Pyrhonen S, James RD, et al. Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer. Lancet 1998;352:1413–8CrossRef Cunningham D, Pyrhonen S, James RD, et al. Randomised trial of irinotecan plus supportive care versus supportive care alone after fluorouracil failure for patients with metastatic colorectal cancer. Lancet 1998;352:1413–8CrossRef
27.
Zurück zum Zitat Nordlinger B, Guiguet M, Vaillant JC, et al. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer 1996;77:1254–62CrossRef Nordlinger B, Guiguet M, Vaillant JC, et al. Surgical resection of colorectal carcinoma metastases to the liver. A prognostic scoring system to improve case selection, based on 1568 patients. Association Francaise de Chirurgie. Cancer 1996;77:1254–62CrossRef
28.
Zurück zum Zitat Scheele J, Stangl R, Altendorf-Hofmann A, Gall FP. Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 1991;110:13–29PubMed Scheele J, Stangl R, Altendorf-Hofmann A, Gall FP. Indicators of prognosis after hepatic resection for colorectal secondaries. Surgery 1991;110:13–29PubMed
29.
Zurück zum Zitat Kemeny N, Huang Y, Cohen AM, et al. Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N Engl J Med 1999;341:2039–48CrossRef Kemeny N, Huang Y, Cohen AM, et al. Hepatic arterial infusion of chemotherapy after resection of hepatic metastases from colorectal cancer. N Engl J Med 1999;341:2039–48CrossRef
30.
Zurück zum Zitat Flesch R. A new readability yardstick. J Appl Psychol 1948;32:221–33CrossRef Flesch R. A new readability yardstick. J Appl Psychol 1948;32:221–33CrossRef
31.
Zurück zum Zitat Sonpavde G. Communicating the value of adjuvant chemotherapy. J Clin Oncol 2003;21:948–9CrossRef Sonpavde G. Communicating the value of adjuvant chemotherapy. J Clin Oncol 2003;21:948–9CrossRef
32.
Zurück zum Zitat Weinfurt KP, Depuy V, Castel LD, Sulmasy DP, Schulman KA, Meropol NJ. Understanding of an aggregate probability statement by patients who are offered participation in phase I clinical trials. Cancer 2005;103:140–7. CrossRef Weinfurt KP, Depuy V, Castel LD, Sulmasy DP, Schulman KA, Meropol NJ. Understanding of an aggregate probability statement by patients who are offered participation in phase I clinical trials. Cancer 2005;103:140–7. CrossRef
33.
Zurück zum Zitat Maindrault-Goebel F, Louvet C, Andre T, et al. Oxaliplatin added to the simplified bimonthly leucovorin and 5-fluorouracil regimen as second-line therapy for metastatic colorectal cancer (FOLFOX6). GERCOR. Eur J Cancer 1999;35:1338–42CrossRef Maindrault-Goebel F, Louvet C, Andre T, et al. Oxaliplatin added to the simplified bimonthly leucovorin and 5-fluorouracil regimen as second-line therapy for metastatic colorectal cancer (FOLFOX6). GERCOR. Eur J Cancer 1999;35:1338–42CrossRef
34.
Zurück zum Zitat Saltz LB, Cox JV, Blanke C, et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 2000;343:905–14CrossRef Saltz LB, Cox JV, Blanke C, et al. Irinotecan plus fluorouracil and leucovorin for metastatic colorectal cancer. Irinotecan Study Group. N Engl J Med 2000;343:905–14CrossRef
35.
Zurück zum Zitat Kemeny MM, Adak S, Gray B, et al. Combined-modality treatment for resectable metastatic colorectal carcinoma to the liver: surgical resection of hepatic metastases in combination with continuous infusion of chemotherapy—an intergroup study. J Clin Oncol 2002;20:1499–505PubMed Kemeny MM, Adak S, Gray B, et al. Combined-modality treatment for resectable metastatic colorectal carcinoma to the liver: surgical resection of hepatic metastases in combination with continuous infusion of chemotherapy—an intergroup study. J Clin Oncol 2002;20:1499–505PubMed
36.
Zurück zum Zitat Fong Y, Blumgart LH, Cohen A, Fortner J, Brennan MF. Repeat hepatic resections for metastatic colorectal cancer. Ann Surg 1994;220:657–62CrossRef Fong Y, Blumgart LH, Cohen A, Fortner J, Brennan MF. Repeat hepatic resections for metastatic colorectal cancer. Ann Surg 1994;220:657–62CrossRef
37.
Zurück zum Zitat Petrowsky H, Gonen M, Jarnagin W, et al. Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: a bi-institutional analysis. Ann Surg 2002;235:863–71CrossRef Petrowsky H, Gonen M, Jarnagin W, et al. Second liver resections are safe and effective treatment for recurrent hepatic metastases from colorectal cancer: a bi-institutional analysis. Ann Surg 2002;235:863–71CrossRef
38.
Zurück zum Zitat Nordlinger B, Rougier P. Liver metastases from colorectal cancer: the turning point. J Clin Oncol 2002;20:1442–5CrossRef Nordlinger B, Rougier P. Liver metastases from colorectal cancer: the turning point. J Clin Oncol 2002;20:1442–5CrossRef
39.
Zurück zum Zitat Chao C, Studts JL, Abell T, et al. Adjuvant chemotherapy for breast cancer: how presentation of recurrence risk influences decision-making. J Clin Oncol 2003;21:4299–305CrossRef Chao C, Studts JL, Abell T, et al. Adjuvant chemotherapy for breast cancer: how presentation of recurrence risk influences decision-making. J Clin Oncol 2003;21:4299–305CrossRef
Metadaten
Titel
Method of Presenting Oncology Treatment Outcomes Influences Patient Treatment Decision-Making in Metastatic Colorectal Cancer
verfasst von
Robert C. G. Martin II, MD
Sheri A. McGuffin, MAE
Lynne M. Roetzer, BA
Troy D. Abell, PhD, MPH
Jamie L. Studts, PhD
Publikationsdatum
01.01.2006
Erschienen in
Annals of Surgical Oncology / Ausgabe 1/2006
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/ASO.2006.03.086

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