Patient preferences in screening for recurrent disease after potentially curative esophagectomy.
BACKGROUND
Routine imaging (RI) as part of follow-up after potentially curative esophagectomy is currently not widely accepted. If detected recurrent disease could be adequately treated, it remains unclear whether patients would want to take part in a screening program. The aim of this study was to determine the extent to which patients who underwent esophagectomy prefer follow-up with or without RI.


METHODS
Patients who underwent esophagectomy for carcinoma without evidence of recurrent disease were included. An interview-administered questionnaire was used to assess fear of recurrence and elicit patient preferences for the frequency and duration of follow-up and hypothetical changes of survival chances (1-10%).


RESULTS
45/54 eligible patients (83%) participated in this study. The majority of patients preferred follow-up with RI (67%) even if screening would not provide a survival benefit; this proportion increased up to 93% if the proposed chances of survival improved. Younger patients and patients with a lower histopathological tumor stage were more likely to desire follow-up with RI.


CONCLUSIONS
Most patients who underwent esophagectomy preferred RI as part of follow-up over outpatient clinic visits only, even if such screening would not provide a survival benefit. Further research is needed to determine the most accurate screening modality and most efficient follow-up interval.
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
R L G M
RL
Blom
P T
PT
Nieuwkerk
M
M
van Heijl
P
P
Bindels
J H G
JH
Klinkenbijl
M A G
MA
Sprangers
M I
MI
van Berge Henegouwen
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D016009:Chi-Square Distribution; D004938:Esophageal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D016629:Esophagectomy; D005239:Fear; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000523:psychology; D057240:Patient Preference; D010808:Physical Examination; D011159:Population Surveillance; D049268:Positron-Emission Tomography; D013997:Time Factors; D014057:Tomography, X-Ray Computed