Patient preferences in screening for recurrent disease after potentially curative esophagectomy

Dig Surg. 2012;29(3):206-12. doi: 10.1159/000338256. Epub 2012 Jun 8.

Abstract

Background: Routine imaging (RI) as part of follow-up after potentially curative esophagectomy is currently not widely accepted. If detected recurrent disease could be adequately treated, it remains unclear whether patients would want to take part in a screening program. The aim of this study was to determine the extent to which patients who underwent esophagectomy prefer follow-up with or without RI.

Methods: Patients who underwent esophagectomy for carcinoma without evidence of recurrent disease were included. An interview-administered questionnaire was used to assess fear of recurrence and elicit patient preferences for the frequency and duration of follow-up and hypothetical changes of survival chances (1-10%).

Results: 45/54 eligible patients (83%) participated in this study. The majority of patients preferred follow-up with RI (67%) even if screening would not provide a survival benefit; this proportion increased up to 93% if the proposed chances of survival improved. Younger patients and patients with a lower histopathological tumor stage were more likely to desire follow-up with RI.

Conclusion: Most patients who underwent esophagectomy preferred RI as part of follow-up over outpatient clinic visits only, even if such screening would not provide a survival benefit. Further research is needed to determine the most accurate screening modality and most efficient follow-up interval.

MeSH terms

  • Adenocarcinoma / diagnostic imaging
  • Adenocarcinoma / surgery*
  • Aged
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / surgery*
  • Chi-Square Distribution
  • Esophageal Neoplasms / diagnostic imaging
  • Esophageal Neoplasms / surgery*
  • Esophagectomy
  • Fear
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Multimodal Imaging
  • Multivariate Analysis
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / diagnostic imaging
  • Neoplasm Recurrence, Local / psychology
  • Patient Preference*
  • Physical Examination
  • Population Surveillance*
  • Positron-Emission Tomography
  • Time Factors
  • Tomography, X-Ray Computed