Kim Tae-Han, Kim In-Ho, Kang Seung Joo, Song Geum Jong, Jung Mi Ran, Han Hye Sook, Nam Su Youn, Kong Seong-Ho
Department of Surgery, Gyeongsang National University Changwon Hospital, Changwon, Korea.
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
J Gastric Cancer. 2025 Jul;25(3):478-496. doi: 10.5230/jgc.2025.25.e35.
Decisions regarding gastric cancer treatment affect patient outcomes and quality of life (QOL); nonetheless, factors influencing patient preferences remain unclear. This study investigated the preferences for the extent of gastrectomy, minimally invasive surgery, and adjuvant therapy while identifying the key determinants.
A cross-sectional survey of 240 respondents, including patients with gastric cancer and the general population, assessed their preferences for the extent of gastrectomy, surgical modality, adjuvant therapy, palliative systemic therapy, and endoscopic therapy. Correlations between demographic variables and treatment choices were statistically analyzed.
Patients prioritized expert recommendations for determining the extent of gastrectomy for proximal gastric cancer and selecting the surgical modality, with recurrence risk and surgical complications being the primary considerations. In terms of adjuvant therapy, a 12-month oral regimen was preferred over a 6-month oral plus injection regimen, with survival benefit being the most valued factor. Conversely, QOL was a primary concern in palliative therapy. With respect to incomplete endoscopic submucosal dissection, electrocauterization was the preferred approach, followed by surgical resection; local recurrence risk was assigned with the highest priority, followed by concerns regarding lymph node metastasis. Men and individuals living alone had a lower risk of recurrence and lymph node metastasis. Patients undergoing gastric cancer treatment preferred shorter procedures, whereas medical personnel emphasized surgical safety and efficiency.
Demographic and clinical factors significantly influence patient preferences. Understanding these preferences is essential for shared decision-making and personalized oncological care.
关于胃癌治疗的决策会影响患者的治疗结果和生活质量(QOL);然而,影响患者偏好的因素仍不明确。本研究调查了患者对胃切除术范围、微创手术和辅助治疗的偏好,同时确定关键决定因素。
对240名受访者进行横断面调查,包括胃癌患者和普通人群,评估他们对胃切除术范围、手术方式、辅助治疗、姑息性全身治疗和内镜治疗的偏好。对人口统计学变量与治疗选择之间的相关性进行统计学分析。
患者在确定近端胃癌胃切除术范围和选择手术方式时优先考虑专家建议,复发风险和手术并发症是主要考虑因素。在辅助治疗方面,12个月的口服方案比6个月的口服加注射方案更受青睐,生存获益是最受重视的因素。相反,生活质量是姑息治疗中的主要关注点。对于内镜黏膜下剥离术不完全的情况,电灼是首选方法,其次是手术切除;局部复发风险被列为最高优先级,其次是对淋巴结转移的担忧。男性和独居者复发和淋巴结转移的风险较低。接受胃癌治疗的患者更喜欢较短的手术过程,而医务人员则强调手术安全性和效率。
人口统计学和临床因素显著影响患者偏好。了解这些偏好对于共同决策和个性化肿瘤治疗至关重要。