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2022-RA-854-ESGO Giving prognostic information by using scenarios – attitudes of women with gynecological cancer
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  1. Maren Paus Reinertsen1,2,
  2. Heidi Liland1,
  3. Ala Jabri Haug3,
  4. Jordi Deu Martinez4,
  5. Martin R Stockler5,
  6. Guro Aune6,
  7. Belinda E Kiely5,
  8. Torbjørn Paulsen1,
  9. Ingvild Vistad7,8 and
  10. Kristina Lindemann1,9
  1. 1Department of gynecologic oncology, Oslo University Hospital, Oslo, Norway
  2. 2Jagiellonian University Medical College, Kraków, Poland
  3. 3Department of Obstetrics and Gynecology, Akershus University Hospital, Lorenskog, Norway
  4. 4Department of Obstetrics and Gynecology, Telemarks Regional Hospital, Skien, Norway
  5. 5National Health and Medical Research Council – Clinical Trials Centre, University of Sydney, Camperdown, NSW, Australia
  6. 6Department of Obstetrics and Gynecology, St Olav Hospital, Trondheim, Norway
  7. 7Department of Obstetrics and Gynecology, Sorlandet Hospital HF, Kristiansand, Norway
  8. 8Clinical department 2, University of Bergen, Bergen, Norway
  9. 9Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway

Abstract

Introduction/Background Providing prognostic information is considered challenging, and as a consequence, such information is often not discussed. Communication of 3 scenarios to explain survival times has been shown to provide an accurate view of prognosis that leaves room for realistic hope. However, little is known about the preferences for prognostic information among women with gynecological cancer.

Methodology This cross-sectional survey recruited women with gynecological cancers at 5 sites in Norway. The survey described 2 formats for explaining life expectancy to a hypothetical patient with advanced cancer—providing either 3 scenarios for survival (best case, worst case, and typical scenario) or just the median survival time.

Results A total of 252 women were recruited. 122 (48%) were on current anti-cancer treatment. Participants had primary cancer of the ovaries 110 (44%), corpus 61 (24%), and cervix 52 (21%). Only 35% of responders recalled to have received prognostic information, and out of those that did not, 51% would have liked to receive such information. More participants agreed that explaining 3 scenarios (vs. median survival) would make sense (81% vs. 74%), help to plan for the future (71% vs. 65%), and convey hope (58% vs. 38%), while fewer respondents agreed that explaining 3 scenarios (vs. median survival) would upset people (29% vs. 39%). Even if the presentation of the worst-case scenario was upsetting (51%), the vast majority felt that it improved their understanding of survival times (72%). 41% would prefer both the median and 3 scenarios to be discussed when prognostic information is given.

Conclusion Only a third of women recalled to have received prognostic information. We recommend the 3 scenarios to be included when giving prognostic information, but it seems important to make sure the patient wishes to receive such information.

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