Patient preferences for active surveillance vs standard surgery after neoadjuvant chemoradiotherapy in oesophageal cancer treatment: The NOSANO-study

Merel Hermus*, Berend J. van der Wilk, Rebecca T.H. Chang, Gerlise Collee, Bo J. Noordman, Peter Paul L.O. Coene, Jan Willem T. Dekker, Henk H. Hartgrink, Joos Heisterkamp, Grard A.P. Nieuwenhuijzen, Camiel Rosman, Liesbeth Timmermans, Bas P.L. Wijnhoven, Charlène J. van der Zijden, Jan J. Busschbach, J. Jan B. van Lanschot, Sjoerd M. Lagarde, Leonieke W. Kranenburg

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Active surveillance may be a safe and effective treatment in oesophageal cancer patients with a clinically complete response after neoadjuvant chemoradiotherapy (nCRT). In the NOSANO-study we gained insight in patients' motive to opt for either an experimental treatment called active surveillance or for standard immediate surgery. Both qualitative and quantitative analyses methods were used. Forty patients were interviewed about their treatment preference, 3 months after completion of nCRT (T1). Data were recorded, transcribed verbatim and analysed according to the principles of grounded theory. In addition, at T1 and T2 (12 months after completion of nCRT) questionnaires on health-related quality of life, coping, anxiety and decisional regret (only T2) were administered. Interview data analyses resulted in a conceptual model with ‘dealing with threat of cancer’ as the central theme. Patients preferring active surveillance tend to cope with this threat by confiding in their bodies and good outcomes. Their mind-set is one of ‘enjoy life now’. Patients preferring surgery tend to cope by minimizing uncertainty and eliminating the source of cancer. Their mind-set is one of ‘don't give up, act now’. Furthermore, questionnaire results showed that patients with a preference for standard surgery had a lower quality of life. Patient preferences are individualized and thus difficult to predict. Our model can help healthcare professionals to determine patient preferences for treatment. Coping style and mind-set seem to be determining factors here.

Original languageEnglish
Pages (from-to)1183-1190
Number of pages8
JournalInternational Journal of Cancer
Volume152
Issue number6
DOIs
Publication statusE-pub ahead of print - 27 Oct 2022

Bibliographical note

Funding information:
Maag Lever Darm Stichting, Grant/Award
Number: ZP-18-13

Publisher Copyright:
© 2022 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

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