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 for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)3604-3610
Number of pages7
JournalLaryngoscope
Volume134
Issue number8
Early online date1 Feb 2024
DOIs
Publication statusPublished - Aug 2024

Keywords

  • counseling
  • decisional conflict
  • decision-making
  • laryngectomy
  • larynx cancer
  • QUALITY-OF-LIFE
  • PSYCHOMETRIC PROPERTIES
  • MAKING QUESTIONNAIRE
  • ORGAN PRESERVATION
  • CANCER PATIENTS
  • RADIATION
  • SURGERY
  • CHEMORADIATION
  • VALIDATION
  • SURVIVAL

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