Treatment Preferences for Routine Lymphadenectomy Versus No Lymphadenectomy in Early-Stage Endometrial Cancer

Jung Yun Lee, Kyunghoon Kim, Yun Shin Lee, Hyo Young Kim, Eun Ji Nam, Sunghoon Kim, Sang Wun Kim, Jae Weon Kim, YoungTae Kim

Research output: Contribution to journalArticle

Abstract

Background: Debate on the value of lymphadenectomy continues in endometrial cancer. The aim of this study was to investigate patient and clinician preferences for routine lymphadenectomy versus no lymphadenectomy in the surgical management of endometrial cancer. Methods: A discrete choice experiment and trade-off question were designed and distributed to 103 endometrial cancer patients and 90 gynecologic oncologists. Participant preferences were quantified with regression analysis using scenarios based on three attributes: 5-year progression-free survival and the rates of acute and chronic complication. A trade-off technique varying the risk of recurrence for no lymphadenectomy was used to quantify any additional risk of recurrence that these participants would accept to receive no lymphadenectomy instead of routine lymphadenectomy. Results: On the basis of discrete choice experiment, the recurrence rate and lymphedema risk had a statistically significant impact on respondents’ preference. The trade-off question showed that the median additional accepted risk of having no lymphadenectomy was 2.8% for gynecologic oncologists (0.5–14%) and 3.0% for patients (0.5–10%), but this difference was not significant (p = 0.620). Patients who were younger or had a higher education level or no history of delivery or shorter duration since diagnosis were prepared to accept higher additional risks of having no lymphadenectomy. Conclusions: Our results show that the majority of endometrial cancer patients and clinicians will accept a small amount of recurrence risk to reduce the incidence of lymphedema. Regarding preference heterogeneity among patients, our results show that it is important for surgeons to take a patient-tailored approach when discussing surgical management.

Original languageEnglish
Pages (from-to)1336-1342
Number of pages7
JournalAnnals of Surgical Oncology
Volume24
Issue number5
DOIs
Publication statusPublished - 2017 May 1

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Endometrial Neoplasms
Lymph Node Excision
Recurrence
Lymphedema
Therapeutics
Patient Preference
Disease-Free Survival
Survival Rate
Regression Analysis
Education
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Lee, Jung Yun ; Kim, Kyunghoon ; Lee, Yun Shin ; Kim, Hyo Young ; Nam, Eun Ji ; Kim, Sunghoon ; Kim, Sang Wun ; Kim, Jae Weon ; Kim, YoungTae. / Treatment Preferences for Routine Lymphadenectomy Versus No Lymphadenectomy in Early-Stage Endometrial Cancer. In: Annals of Surgical Oncology. 2017 ; Vol. 24, No. 5. pp. 1336-1342.
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abstract = "Background: Debate on the value of lymphadenectomy continues in endometrial cancer. The aim of this study was to investigate patient and clinician preferences for routine lymphadenectomy versus no lymphadenectomy in the surgical management of endometrial cancer. Methods: A discrete choice experiment and trade-off question were designed and distributed to 103 endometrial cancer patients and 90 gynecologic oncologists. Participant preferences were quantified with regression analysis using scenarios based on three attributes: 5-year progression-free survival and the rates of acute and chronic complication. A trade-off technique varying the risk of recurrence for no lymphadenectomy was used to quantify any additional risk of recurrence that these participants would accept to receive no lymphadenectomy instead of routine lymphadenectomy. Results: On the basis of discrete choice experiment, the recurrence rate and lymphedema risk had a statistically significant impact on respondents’ preference. The trade-off question showed that the median additional accepted risk of having no lymphadenectomy was 2.8{\%} for gynecologic oncologists (0.5–14{\%}) and 3.0{\%} for patients (0.5–10{\%}), but this difference was not significant (p = 0.620). Patients who were younger or had a higher education level or no history of delivery or shorter duration since diagnosis were prepared to accept higher additional risks of having no lymphadenectomy. Conclusions: Our results show that the majority of endometrial cancer patients and clinicians will accept a small amount of recurrence risk to reduce the incidence of lymphedema. Regarding preference heterogeneity among patients, our results show that it is important for surgeons to take a patient-tailored approach when discussing surgical management.",
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Treatment Preferences for Routine Lymphadenectomy Versus No Lymphadenectomy in Early-Stage Endometrial Cancer. / Lee, Jung Yun; Kim, Kyunghoon; Lee, Yun Shin; Kim, Hyo Young; Nam, Eun Ji; Kim, Sunghoon; Kim, Sang Wun; Kim, Jae Weon; Kim, YoungTae.

In: Annals of Surgical Oncology, Vol. 24, No. 5, 01.05.2017, p. 1336-1342.

Research output: Contribution to journalArticle

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T1 - Treatment Preferences for Routine Lymphadenectomy Versus No Lymphadenectomy in Early-Stage Endometrial Cancer

AU - Lee, Jung Yun

AU - Kim, Kyunghoon

AU - Lee, Yun Shin

AU - Kim, Hyo Young

AU - Nam, Eun Ji

AU - Kim, Sunghoon

AU - Kim, Sang Wun

AU - Kim, Jae Weon

AU - Kim, YoungTae

PY - 2017/5/1

Y1 - 2017/5/1

N2 - Background: Debate on the value of lymphadenectomy continues in endometrial cancer. The aim of this study was to investigate patient and clinician preferences for routine lymphadenectomy versus no lymphadenectomy in the surgical management of endometrial cancer. Methods: A discrete choice experiment and trade-off question were designed and distributed to 103 endometrial cancer patients and 90 gynecologic oncologists. Participant preferences were quantified with regression analysis using scenarios based on three attributes: 5-year progression-free survival and the rates of acute and chronic complication. A trade-off technique varying the risk of recurrence for no lymphadenectomy was used to quantify any additional risk of recurrence that these participants would accept to receive no lymphadenectomy instead of routine lymphadenectomy. Results: On the basis of discrete choice experiment, the recurrence rate and lymphedema risk had a statistically significant impact on respondents’ preference. The trade-off question showed that the median additional accepted risk of having no lymphadenectomy was 2.8% for gynecologic oncologists (0.5–14%) and 3.0% for patients (0.5–10%), but this difference was not significant (p = 0.620). Patients who were younger or had a higher education level or no history of delivery or shorter duration since diagnosis were prepared to accept higher additional risks of having no lymphadenectomy. Conclusions: Our results show that the majority of endometrial cancer patients and clinicians will accept a small amount of recurrence risk to reduce the incidence of lymphedema. Regarding preference heterogeneity among patients, our results show that it is important for surgeons to take a patient-tailored approach when discussing surgical management.

AB - Background: Debate on the value of lymphadenectomy continues in endometrial cancer. The aim of this study was to investigate patient and clinician preferences for routine lymphadenectomy versus no lymphadenectomy in the surgical management of endometrial cancer. Methods: A discrete choice experiment and trade-off question were designed and distributed to 103 endometrial cancer patients and 90 gynecologic oncologists. Participant preferences were quantified with regression analysis using scenarios based on three attributes: 5-year progression-free survival and the rates of acute and chronic complication. A trade-off technique varying the risk of recurrence for no lymphadenectomy was used to quantify any additional risk of recurrence that these participants would accept to receive no lymphadenectomy instead of routine lymphadenectomy. Results: On the basis of discrete choice experiment, the recurrence rate and lymphedema risk had a statistically significant impact on respondents’ preference. The trade-off question showed that the median additional accepted risk of having no lymphadenectomy was 2.8% for gynecologic oncologists (0.5–14%) and 3.0% for patients (0.5–10%), but this difference was not significant (p = 0.620). Patients who were younger or had a higher education level or no history of delivery or shorter duration since diagnosis were prepared to accept higher additional risks of having no lymphadenectomy. Conclusions: Our results show that the majority of endometrial cancer patients and clinicians will accept a small amount of recurrence risk to reduce the incidence of lymphedema. Regarding preference heterogeneity among patients, our results show that it is important for surgeons to take a patient-tailored approach when discussing surgical management.

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