Decision-making preferences in patients with advanced and recurrent endometrial cancer (502)

Abstract

Objectives: To elucidate treatment decision preferences in women diagnosed with advanced or recurrent endometrial cancer. Methods: Women diagnosed with advanced or recurrent endometrial cancer at our institution were invited to participate in a combined survey and structured interview inquiring about decisionmaking preferences and quality-of-life (QOL). Participants completed the FACT-En, controlled preferences survey (shared decision-making survey), and completed questions inquiring about the importance of treatment decision preferences. The participants also underwent a structured interview to collect qualitative information on decision preferences. Descriptive statistics were performed on the data collected. Results: A total of 33 women participated in the survey/interview, reflecting an 89.2% participation rate. The median age of participants was 65.0 years, and 57.6% of participants self-identified as White, 33.3% as Black, and 15.1% as more than one race/other. Endometrioid adenocarcinoma was the most common histology (51.5%), followed by serous carcinoma (24.2%), carcinosarcoma (6.1%), clear cell carcinoma (6.1%), and one each of de-differentiated, mixed de-differenti- ated, and mixed endometrioid/clear cell carcinoma. Fifteen (45.5%) participants each had advanced endometrial cancer (Stage III or IV) and recurrent endometrial cancer, and the remaining three participants had a history of advanced or recurrent endometrial cancer. Among the participants, 29 (87.9%) were on treatment at the time of the study. Participants reported varying importance for ten different treatment considerations, displayed in Table 1. When participants were asked regarding the three most important treatment considerations of the ten options, participants reported physician recommendation (69.7%), treatment efficacy (69.7%), treatment side effects (60.6%), treatment schedule (33.3%), direct cost (18.2%), and <10% reported each of indirect cost, frequency of treatment monitoring, treatment length, and treatment modality. A majority of participants preferred a shared (collaborative) decision-making approach with their physician (n=19, 57.6%). In comparison, the remaining 11 (33%) preferred participating in a decision as an active decision-maker and three (9.1%) as a passive decision-maker. The median QOL score by FACT-En was 137 (IQR: 88) out of 172, and there was no association between shared decision-making preference and QOL score (p>0.05). Conclusions: Limited data exist about patient preferences in advanced, recurrent endometrial cancer. Our study described patient preferences about multiple treatment considerations. Patients with advanced or recurrent endometrial cancer prefer a collaborative, shared decision-making approach when deciding treatment for their cancer. In the setting of expanding treatment options in endometrial cancer, further work on measuring, identifying, and implementing patient preferences into clinical decision-making should be explored. Objectives: To elucidate treatment decision preferences in women diagnosed with advanced or recurrent endometrial cancer. Methods: Women diagnosed with advanced or recurrent endometrial cancer at our institution were invited to participate in a combined survey and structured interview inquiring about decisionmaking preferences and quality-of-life (QOL). Participants completed the FACT-En, controlled preferences survey (shared decision-making survey), and completed questions inquiring about the importance of treatment decision preferences. The participants also underwent a structured interview to collect qualitative information on decision preferences. Descriptive statistics were performed on the data collected. Results: A total of 33 women participated in the survey/interview, reflecting an 89.2% participation rate. The median age of participants was 65.0 years, and 57.6% of participants self-identified as White, 33.3% as Black, and 15.1% as more than one race/other. Endometrioid adenocarcinoma was the most common histology (51.5%), followed by serous carcinoma (24.2%), carcinosarcoma (6.1%), clear cell carcinoma (6.1%), and one each of de-differentiated, mixed de-differenti- ated, and mixed endometrioid/clear cell carcinoma. Fifteen (45.5%) participants each had advanced endometrial cancer (Stage III or IV) and recurrent endometrial cancer, and the remaining three participants had a history of advanced or recurrent endometrial cancer. Among the participants, 29 (87.9%) were on treatment at the time of the study. Participants reported varying importance for ten different treatment considerations, displayed in Table 1. When participants were asked regarding the three most important treatment considerations of the ten options, participants reported physician recommendation (69.7%), treatment efficacy (69.7%), treatment side effects (60.6%), treatment schedule (33.3%), direct cost (18.2%), and <10% reported each of indirect cost, frequency of treatment monitoring, treatment length, and treatment modality. A majority of participants preferred a shared (collaborative) decision-making approach with their physician (n=19, 57.6%). In comparison, the remaining 11 (33%) preferred participating in a decision as an active decision-maker and three (9.1%) as a passive decision-maker. The median QOL score by FACT-En was 137 (IQR: 88) out of 172, and there was no association between shared decision-making preference and QOL score (p>0.05). Conclusions: Limited data exist about patient preferences in advanced, recurrent endometrial cancer. Our study described patient preferences about multiple treatment considerations. Patients with advanced or recurrent endometrial cancer prefer a collaborative, shared decision-making approach when deciding treatment for their cancer. In the setting of expanding treatment options in endometrial cancer, further work on measuring, identifying, and implementing patient preferences into clinical decision-making should be explored.