Accuracy of curability expectations in patients with gastrointestinal cancers Journal Article
| Authors: | Agarwal, R.; Shin, P.; Knezevic, A.; Nelson, J. E.; Romano, D. R.; Bernal, C.; Desai, A. V.; Epstein, A. S. |
| Article Title: | Accuracy of curability expectations in patients with gastrointestinal cancers |
| Abstract: | Background: Assessment of illness and treatment understanding among cancer patients has largely focused on those with advanced disease. Less is known about patient expectations at earlier stages of cancer and potential modifiers of accurate understanding. Methods: We assessed accuracy of cure expectations in patients across all stages with gastrointestinal (GI) cancers. Accuracy was determined by independent reviews of patient health records by oncologists on the investigative team. Impact on cure accuracy of selected clinical variables and health-information preferences was analyzed. Results: Hundred and thirty five patients were included for analysis, with 100% interrater agreement for accuracy between oncologist reviewers. Sixety five patients (48%) had accurate cure expectations from their cancer treatment. Accuracy was lower in Stage IV versus Stage I–III disease (35% vs. 63%, p < 0.01), lower in unresectable versus resectable disease (35% vs. 67%, p < 0.01), and higher in patients with early-stage disease who received adjuvant chemotherapy versus those who did not (78% vs. 53%, p = 0.04). Accuracy did not differ by health-information preferences and remained stable over time. Of 63 patients who died, baseline accuracy differed by location of death (p = 0.03), with greater accuracy in those who died with home hospice (56%). Accuracy was lower in those who were hospitalized in the last 30 days of life versus those who were not (25% vs. 59%, p = 0.01). Conclusions: Inaccurate cure expectations are prevalent across all stages of GI cancers, but particularly among those with metastatic or unresectable disease. High-quality, iterative communication strategies may facilitate patient illness and treatment understanding throughout the disease course. © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. |
| Keywords: | motivation; gastrointestinal neoplasms; communication; informed consent; gastrointestinal tumor; oncologist; oncologists; advance care planning; gastrointestinal cancers; humans; human; prognostic awareness |
| Journal Title: | Cancer Medicine |
| Volume: | 12 |
| Issue: | 1 |
| ISSN: | 2045-7634 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2023-01-01 |
| Start Page: | 20 |
| End Page: | 29 |
| Language: | English |
| DOI: | 10.1002/cam4.4947 |
| PUBMED: | 35959986 |
| PROVIDER: | scopus |
| PMCID: | PMC9844646 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding author is Andrew Epstein -- Export Date: 1 February 2023 -- Source: Scopus |
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