Patient and physician preferences for surgical and adjuvant treatment options for rectal cancer.
OBJECTIVE
Patients and their clinicians hold varying preferences for surgical and adjuvant treatment therapies for rectal cancer.


METHODS
Preferences were determined using the Prospective Measure of Preference.


METHODS
Royal Prince Alfred and St Vincent's hospitals in Sydney, Australia.


METHODS
Patients with colorectal cancer were interviewed during their postoperative hospital stay, and physicians were asked to complete a mailed survey.


METHODS
The Prospective Measure of Preference method produces 2 outcome measures of preference: willingness to trade and prospective measure of preference time trade-off.


RESULTS
Patients' strongest preference was to avoid a stoma: more than 60% would give up a mean of 34% of their life expectancy to avoid this surgical option. This was followed by treatment options involving chemoradiotherapy, where more than 50% would give up a mean of almost 25% of their life to avoid treatment. Surgeons held stronger preferences against all adjuvant options compared with oncologists (P </= .01).


CONCLUSIONS
Patients had strong preferences against all treatment options, and these preferences frequently differed from those of physicians. These results highlight the importance of determining patients' own preferences in the clinical encounter. Furthermore, the diversity of preferences of clinical subspecialists emphasizes the need for multidisciplinary treatment planning to ensure a balanced approach to treatment decision making for patients with rectal cancer.
Harrison
James D
JD
BSc(Hons), Surgical Outcomes Research Centre, Royal Prince Alfred Hospital, PO Box M157, Missenden Road, Sydney, New South Wales, Australia 2050. james.harrison@email.cs.nsw.gov.au
Solomon
Michael J
MJ
Young
Jane M
JM
Meagher
Alan
A
Butow
Phyllis
P
Salkeld
Glenn
G
Hruby
George
G
Clarke
Stephen
S
D017024:Chemotherapy, Adjuvant; D016009:Chi-Square Distribution; D003107:Colorectal Surgery / Q000379:methods*; D003657:Decision Making; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008297:Male; D010358:Patient Participation; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D012004:Rectal Neoplasms / Q000601:surgery*; D011795:Surveys and Questionnaires