Decisional Conflict in Patients with Advanced Laryngeal Carcinoma: A Multicenter Study

Anne N. Heirman, Daan P. de Kort, Japke F. Petersen, Abrahim Al-Mamgani, Simone E.J. Eerenstein, Bertram J. de Kleijn, Frank Hoebers, Bernard M. Tijink, Martijn M. Stuiver, Lisette van der Molen, Richard Dirven, Gyorgy B. Halmos, Michiel W.M. van den Brekel*

*Corresponding author voor dit werk

OnderzoeksoutputAcademicpeer review

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Objectives: Decision-making for patients with a locally advanced laryngeal carcinoma (T3 and T4) is challenging due to the treatment choice between organ preservation and laryngectomy, both with different and high impact on function and quality of life (QoL). The complexity of these treatment decisions and their possible consequences might lead to decisional conflict (DC). This study aimed to explore the level of DC in locally advanced laryngeal carcinoma patients facing curative decision-making, and to identify possible associated factors. 

Methods: In this multicenter prospective cohort study, participants completed questionnaires on DC, level of shared decision-making (SDM), and a knowledge test directly after counseling and 6 months after treatment. Descriptive statistics and Spearman correlation tests were used to analyze the data. 

Results: Directly after counseling, almost all participants (44/45; 98%) experienced Clinically Significant DC score (CSDC >25, scale 0–100). On average, patients scored 47% (SD 20%) correct on the knowledge test. Questions related to radiotherapy were answered best (69%, SD 29%), whilst only 35% (SD 29%) of the questions related to laryngectomy were answered correctly. Patients' perceived level of SDM (scale 0–100) was 70 (mean, SD 16.2), and for physicians this was 70 (SD 1.7). 

Conclusion: Most patients with advanced larynx cancer experience high levels of DC. Low knowledge levels regarding treatment aspects indicate a need for better patient counseling. 

Level of Evidence: 4 Laryngoscope, 134:3604–3610, 2024.

Originele taal-2English
Pagina's (van-tot)3604-3610
Aantal pagina's7
TijdschriftLaryngoscope
Volume134
Nummer van het tijdschrift8
DOI's
StatusPublished - aug.-2024

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