Article Text
Abstract
Introduction/Background Over 200 articles about the sentinel lymph node procedure (SNP) in endometrial cancer (EC) have been published in the last decade, but none assesses patients‘ and gynaecologists’ views on this innovative technique. In this vignette study we established which factors are important for both patients and gynaecologists when considering SNP in EC.
Methodology Based on literature and patients‘ and gynaecologists’ interviews, a list of attributes regarding SNP was composed: 1)risk of complications of SNP, 2)chance of finding a metastasis, 3)survival gain, 4)risk of complications after radiotherapy, 5)additional operation time and 6)hospital of surgery (travel time). A questionnaire with eighteen hypothetical scenarios was developed, in which the levels of each attribute varied. Patients previously treated for low or intermediate risk EC and gynaecologists with interest in oncology were invited to participate. In each scenario they were asked how strongly they would prefer SNP on a scale from 1 to 7. The strength of preference for each scenario was analyzed using a mixed model.
Results Both patients (41/108) and gynaecologists (42/126) had a preference for SNP. On a scale from 1–7 the mean overall preference for patients was 4.29 (95% CI 3.72–4.85) and 4.39 (95% CI 3.99–4.78) for gynaecologists. Patients‘ preferences increased from 3.4 in case of no survival gain to 4.9 in case of three years survival gain (P=0.000), and decreased when travel time increased to over 60 minutes (-0.4, P=0.024) or with an increased risk of complications after adjuvant radiotherapy (-0.6, P=0.002). The chance of finding a metastasis was not important to patients. For gynaecologists all attributes except travel time were significantly important.
Conclusion This study is the first to describe several characteristics being important for patients and gynaecologists when considering SNP in low and intermediate risk EC management. This study can guide counselling of patients when considering SNP.
Disclosure Nothing to disclose.