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1011 Implementation of a personalized risk model for lymph node metastasis in endometrial carcinoma in clinical practice: health care providers’ perspectives on use barriers and facilitators
  1. Marike S Lombaers1,
  2. Stephanie W Vrede1,
  3. Casper Reijnen1,
  4. Dorry Boll2,
  5. Nicole Visser3,
  6. Johanna MA Pijnenborg1,
  7. Nicole PM Ezendam4 and
  8. Rosella Hermens1
  1. 1Radboud University Medical Center, Nijmegen, The Netherlands
  2. 2Catharina Hospital, Eindhoven, The Netherlands
  3. 3Eurofins PAMM, Eindhoven, The Netherlands
  4. 4Netherlands Comprehensive Cancer Organization, Eindhoven, The Netherlands


Introduction/Background The European guideline for endometrial cancer (EC) advises lymph node staging for patients with high-intermediate-risk/high-risk disease. The ENDORISK-model can estimate risk of lymph node metastases (LNM) more accurately by combining preoperative biomarkers. Despite the development of several EC risk models, limited literature is available on clinical implementation. With this qualitative study we aim to study healthcare providers’ (HCP) perspectives on the use of such a risk model and on barriers and facilitators for implementation into clinical practice.

Methodology We performed a focus group study amongst HCP within the EC care process in three oncological care regions in the Netherlands and a sample from several other hospitals within the Netherlands, on general use of ENDORISK-model in daily practice and barriers and facilitators for implementation using a semi-structured interview guide based on the Grol and Wensing model (2004).

Results Focus groups (n=8) were organized with gynaecologists, pathologists radiation oncologists and a nurse specialist. Participants agreed that a risk model predicting LNM could support counseling of patients and shared decision making for optimal treatment, both surgical and adjuvant. A risk cut-off of 10% was suggested above which lymph node staging should be performed. Barriers for implementation were: 1. difficulty in explaining the model and risk estimation to patients, 2. difference in preoperative tests preferred by general versus university hospitals and 3. use in perspective of the sentinel node procedure. Facilitators for implementation were 1. a guideline for the model, with a clear risk cut-off, and for counseling patients, 2. ease of use and reach, and 3. implementation within an oncological network at once.

Conclusion Based on the perspectives of HCP, the ENDORISK-model provides additional value to current care for counseling of patients. Implementation could be facilitated if the ENDORISK-model is easy to understand and use, and supported by guidelines to use the model to counsel patients.

Disclosures None.

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