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Published on: June 9, 2023
Decoding patient preferences: key drivers in selecting thyroid cancer surgery- a discrete choice experiment
Shiwei Zhou1, Yu Mao1,2, Peng Wu1
1Department of Thyroid Surgery, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, Hunan, China.
Frontiers in Endocrinology
|July 2, 2026
Summary
Papillary thyroid carcinoma (PTC) patients prioritize lower recurrence rates and scarless options when choosing surgery. Surgeons should discuss patient values to improve shared decision-making for thyroidectomy.
Area of Science:
- Endocrinology
- Surgical Oncology
- Patient-Reported Outcomes
Background:
- Transoral endoscopic thyroidectomy vestibular approach (TOETVA) is increasingly used for papillary thyroid carcinoma (PTC).
- Understanding patient preferences is crucial for informed decision-making in PTC treatment.
Purpose of the Study:
- To identify key factors influencing surgical choices for patients with PTC.
- To analyze patient preferences regarding surgical attributes and willingness to pay.
Main Methods:
- Discrete choice experiment involving 271 PTC patients scheduled for thyroidectomy.
- Evaluation of hypothetical scenarios based on incision location, size, recurrence rate, operative duration, complication rate, and cost.
- Analysis using a mixed logit model to determine preferences and willingness to pay (WTP).
Main Results:
- Patients strongly preferred lower recurrence rates and scarless surgical approaches.
- Significant WTP observed for reduced recurrence risk (¥201,409.60 for 1% vs. 10%) and scarless options (¥19,141.14).
- Recurrence rate (β = 8.18) was the most critical non-financial factor, followed by incision location (β = 0.78) and complication rate (β = 0.25). Demographic factors influenced cosmetic concerns.
Conclusions:
- Recurrence risk and cosmetic outcomes are primary drivers of surgical preference in PTC patients.
- Postoperative cosmetic concerns differ across demographic groups.
- Surgeons should incorporate patient-specific values into preoperative consultations for enhanced shared decision-making.
