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Decisional Conflict in Patients with Advanced Laryngeal Carcinoma: A Multicenter Study
Anne N Heirman1, Daan P de Kort1, Japke F Petersen1
1Department of Head-and-Neck Oncology and Surgery, Netherlands Cancer Institute - Antoni van Leeuwenhoek, Amsterdam, The Netherlands.
The Laryngoscope
|February 17, 2024
Summary
Patients with advanced larynx cancer experience significant decisional conflict (DC) when choosing between organ preservation and laryngectomy. Improved patient counseling is needed, as knowledge about treatment options is often low.
Area of Science:
- Otolaryngology
- Oncology
- Decision Science
Background:
- Locally advanced laryngeal carcinoma (T3-T4) presents complex treatment choices between organ preservation and laryngectomy.
- These choices significantly impact patient function and quality of life (QoL).
- Treatment complexity can lead to decisional conflict (DC).
Purpose of the Study:
- To explore the level of decisional conflict (DC) in patients with locally advanced laryngeal carcinoma.
- To identify factors associated with DC in this patient population.
Main Methods:
- Multicenter prospective cohort study.
- Participants completed questionnaires on DC, shared decision-making (SDM), and knowledge post-counseling and 6 months post-treatment.
- Descriptive statistics and Spearman correlation analyzed data.
Main Results:
- 98% of patients experienced clinically significant DC post-counseling.
- Average knowledge test score was 47%, with lower scores for laryngectomy questions (35%) compared to radiotherapy (69%).
- Patient and physician perceived SDM levels were both 70/100.
Conclusions:
- The majority of advanced larynx cancer patients face high decisional conflict.
- Low patient knowledge regarding treatment options highlights a need for enhanced patient counseling.
- Addressing knowledge gaps is crucial for improving decision-making in laryngeal cancer treatment.
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