دورية أكاديمية
أعرض في EDS

Perception of risk and treatment decisions in the management of differentiated thyroid cancer.

التفاصيل البيبلوغرافية
العنوان: Perception of risk and treatment decisions in the management of differentiated thyroid cancer.
المؤلفون: Schumm MA; Section of Endocrine Surgery, Department of Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA., Shu ML; Section of Endocrine Surgery, Department of Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA., Kim J; Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California, USA., Tseng CH; Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA., Zanocco K; Section of Endocrine Surgery, Department of Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA., Livhits MJ; Section of Endocrine Surgery, Department of Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA., Leung AM; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California, USA.; Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA., Yeh MW; Section of Endocrine Surgery, Department of Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA., Sacks GD; Department of Surgery, New York University Langone Health, New York, New York, USA., Wu JX; Section of Endocrine Surgery, Department of Surgery, University of California, Los Angeles David Geffen School of Medicine, Los Angeles, California, USA.
المصدر: Journal of surgical oncology [J Surg Oncol] 2022 Aug; Vol. 126 (2), pp. 247-256. Date of Electronic Publication: 2022 Mar 22.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Wiley-Liss Country of Publication: United States NLM ID: 0222643 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1096-9098 (Electronic) Linking ISSN: 00224790 NLM ISO Abbreviation: J Surg Oncol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2005-> : Hoboken, NJ : Wiley-Liss
Original Publication: New York, Plenum.
مواضيع طبية MeSH: Carcinoma, Papillary*/pathology , Carcinoma, Papillary*/surgery , Thyroid Neoplasms*/epidemiology , Thyroid Neoplasms*/surgery, Humans ; Perception ; Thyroid Cancer, Papillary/surgery ; Thyroidectomy
مستخلص: Background and Objectives: The recent de-escalation of care for differentiated thyroid cancer (DTC) has broadened the range of initial treatment options. We examined the association between physicians' perception of risk and their management of DTC.
Methods: Thyroid specialists were surveyed with four clinical vignettes: (1) indeterminate nodule (2) tall cell variant papillary thyroid cancer (PTC), (3) papillary thyroid microcarcinoma (mPTC), and (4) classic PTC. Participants judged the operative risks and likelihood of structural cancer recurrence associated with more versus less aggressive treatments. A logistic mixed effect model was used to predict treatment choice.
Results: Among 183 respondents (13.4% response rate), 44% were surgical and 56% medical thyroid specialists. Risk estimates and treatment recommendation varied markedly in each case. Respondents' estimated risk of 10-year cancer recurrence after lobectomy for a 2.0-cm PTC ranged from 1% to 53% (interquartile range [IQR]: 3%-12%), with 66% recommending lobectomy and 34% total thyroidectomy. Respondents' estimated 5-year risk of metastastic disease during active surveillance of an 0.8-cm mPTC ranged from 0% to 95% (IQR: 4%-15%), with 36% choosing active surveillance. Overall, differences in perceived risk reduction explained 10.3% of the observed variance in decision-making.
Conclusions: Most of the variation in thyroid cancer treatment aggressiveness is unrelated to perceived risk of cancer recurrence.
(© 2022 Wiley Periodicals LLC.)
التعليقات: Comment in: J Surg Oncol. 2022 Aug;126(2):214-216. (PMID: 35315929)
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معلومات مُعتمدة: This study was supported by the Garry Shandling estate
فهرسة مساهمة: Keywords: behavioral science; decision-making; risk and benefit; thyroid cancer; thyroid surgery; thyroidectomy
تواريخ الأحداث: Date Created: 20220322 Date Completed: 20220712 Latest Revision: 20220712
رمز التحديث: 20221213
DOI: 10.1002/jso.26858
PMID: 35316538
قاعدة البيانات: MEDLINE
الوصف
تدمد:1096-9098
DOI:10.1002/jso.26858