这项研究旨在评估晚期卵巢癌女性指南不遵守的原因,以及这些原因是否因年龄而异。
所有被诊断为晚期卵巢癌的女性,国际妇产科联合会(FIGO)IIb-IV,在2015年至2018年期间从荷兰癌症登记处选择。根据年龄组分析指南不依从的治疗模式和原因。
包括4210名女性,其中34%,33%,26%,8%的患者年龄分别<65、65-75、75-85和≥85岁。随着年龄的增长,接受指南坚持治疗的女性较少(年龄<65岁和≥85岁的女性分别从70%降至2%),仅接受最佳支持治疗的女性较多(年龄<65岁和≥85岁的女性分别为4%至69%).指南不遵守的最普遍原因因年龄而异,包括老年女性的患者偏好。年轻女性的功能状态和疾病程度。
大多数老年女性没有接受遵循指南的护理,患者偏好是做出这一决定的最常见原因。这些知识为当前的治疗决策过程提供了见解,并强调了激发患者治疗偏好的重要性。需要进一步的前瞻性研究来研究女性拒绝指南护理的潜在动机以及共同决策对治疗选择的影响程度。
This study aims to assess the
reasons for
guideline non-adherence in women with advanced stage ovarian cancer and whether these
reasons differ according to age.
All women diagnosed with advanced stage ovarian cancer, International Federation of Gynecology and Obstetrics (FIGO) IIb-IV, between 2015 and 2018 were selected from the Netherlands Cancer Registry. Treatment patterns and
reasons for
guideline non-adherence were analyzed according to age groups.
4210 women were included, of whom 34%, 33%, 26%, and 8% were aged <65, 65-75, 75-85, and ≥85 years respectively. With advancing age, less women received
guideline-adherent treatment (decreasing from 70% to 2% in women aged <65 and ≥85 years respectively) and more women received best supportive care only (ranging from 4% to 69% in women aged <65 and ≥85 years respectively). The most prevalent
reasons for
guideline non-adherence differed according to age and included patient preference in older women, and functional status and extent of disease in younger women.
Most older women did not receive guideline-adherent care and patient preference was the most common reason for this decision. This knowledge provides insight in the current treatment decision-making process and highlights the importance of eliciting patient treatment preferences. Further prospective research is necessary to study the underlying motivation for women to decline guideline care and the extent to which shared decision-making influences treatment choice.