Patient and Physician Preferences for Nonoperative Management for Low Rectal Cancer: Is It a Reasonable Treatment Option?

Diseases of the Colon and Rectum
Erin D KennedyNancy N Baxter

Abstract

Although the body of evidence supporting nonoperative management for rectal cancer has been accumulating, there has been little systematic investigation to explore how physicians and patients value the tradeoffs between oncologic and functional outcomes after abdominal perineal resection and nonoperative management. The purpose of this study was to elicit patient and physician preferences for nonoperative management relative to abdominal perineal resection in the setting of low rectal cancer. We conducted a standardized interviews of patients and a cross-sectional survey of physicians. Patients from 1 tertiary care center and physicians from across Canada were included. The study involved 50 patients who were previously treated for rectal cancer and 363 physicians who treat rectal cancer. Interventions included standardized interviews using the threshold technique with patients and surveys mailed to physicians. We measured absolute increase risk in local regrowth and absolute decrease in overall survival that patients and physicians would accept with nonoperative management relative to abdominal perineal resection. Patients were willing to accept a 20% absolute increase for local regrowth (ie, from 0% to 20%) and a 20% absolute...Continue Reading

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Citations

Apr 12, 2019·The British Journal of Surgery·P Mroczkowski
Jun 25, 2019·JAMA : the Journal of the American Medical Association·Sergio A AcunaNancy N Baxter
Oct 3, 2019·The British Journal of Surgery·P Mroczkowski, L Dziki
Feb 25, 2020·Journal of Surgical Oncology·Adam C FieldsNelya Melnitchouk
Oct 25, 2020·Practical Radiation Oncology·Jennifer Y WoPrajnan Das
Oct 24, 2020·Diseases of the Colon and Rectum·Richard GarfinkleUNKNOWN Management of Uncomplicated Diverticulitis (MUD) Collaborative
Apr 28, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Maxime J M van der ValkDenise E Hilling
Nov 7, 2020·CA: a Cancer Journal for Clinicians·David R ByrdDonna M Gress
Nov 6, 2021·The British Journal of Surgery·Renu R BahadoerUNKNOWN International Watch & Wait Database Consortium (IWWD)

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