Lombaers Marike S, Vrede Stephanie W, Reijnen Casper, Boll Dorry, Visser Nicole C M, Pijnenborg Johanna M A, Ezendam Nicole P M, Hermens Rosella P M G
Department of Obstetrics and Gynecology, Radboud University Medical Center, Nijmegen, the Netherlands.
Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands.
Cancer Med. 2025 Aug;14(15):e71103. doi: 10.1002/cam4.71103.
The ENDORISK model estimates the risk of lymph node metastases (LNM) in endometrial carcinoma (EC) patients using preoperative clinical variables and biomarkers. This qualitative study investigated healthcare providers' (HCP) perspectives on the use of the model and barriers and facilitators for clinical implementation.
Eight focus group interviews were performed among HCPs. A semi-structured interview guide was used based on the Grol and Wensing implementation model.
Focus groups included gynecologists, residents of gynecology, pathologists, radiation oncologists, and a nurse specialist (n = 41). ENDORISK was deemed supportive for counseling of patients and shared decision-making for optimal surgical and adjuvant treatment. Barriers for implementation were difficulty in explaining the model and risk percentages to patients, differences in preoperative diagnostic tools used per hospital, and use of the model with the sentinel node procedure. Facilitators were a clear guideline for using the model with a predefined risk cutoff and making the model easily understandable for patients. A 10% risk cutoff was considered clinically relevant for lymph node assessment.
HCP found ENDORISK use in clinical practice supportive for patient counseling. Future implementation should focus on a user-friendly interface, a cohesive guideline, and training to aid efficient use and counseling of patients.
ENDORISK模型利用术前临床变量和生物标志物评估子宫内膜癌（EC）患者发生淋巴结转移（LNM）的风险。这项定性研究调查了医疗服务提供者（HCP）对该模型使用情况的看法以及临床实施的障碍和促进因素。
对HCP进行了八次焦点小组访谈。基于Grol和Wensing实施模型使用了半结构化访谈指南。
焦点小组包括妇科医生、妇科住院医师、病理学家、放射肿瘤学家和一名护士专家（n = 41）。ENDORISK被认为有助于为患者提供咨询，并为最佳手术和辅助治疗的共同决策提供支持。实施的障碍包括难以向患者解释该模型和风险百分比、各医院术前诊断工具的差异以及该模型与前哨淋巴结手术的联合使用。促进因素包括使用该模型的明确指南以及设定预定义的风险临界值，使该模型易于患者理解。10%的风险临界值被认为在临床上与淋巴结评估相关。
HCP发现在临床实践中使用ENDORISK有助于为患者提供咨询。未来的实施应侧重于用户友好的界面、连贯的指南以及培训，以帮助有效地使用该模型并为患者提供咨询。
