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Treatment Preferences for Routine Lymphadenectomy Versus No Lymphadenectomy in Early-Stage Endometrial Cancer

  • Gynecologic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Debate on the value of lymphadenectomy continues in endometrial cancer. The aim of this study was to investigate patient and clinician preferences for routine lymphadenectomy versus no lymphadenectomy in the surgical management of endometrial cancer.

Methods

A discrete choice experiment and trade-off question were designed and distributed to 103 endometrial cancer patients and 90 gynecologic oncologists. Participant preferences were quantified with regression analysis using scenarios based on three attributes: 5-year progression-free survival and the rates of acute and chronic complication. A trade-off technique varying the risk of recurrence for no lymphadenectomy was used to quantify any additional risk of recurrence that these participants would accept to receive no lymphadenectomy instead of routine lymphadenectomy.

Results

On the basis of discrete choice experiment, the recurrence rate and lymphedema risk had a statistically significant impact on respondents’ preference. The trade-off question showed that the median additional accepted risk of having no lymphadenectomy was 2.8% for gynecologic oncologists (0.5–14%) and 3.0% for patients (0.5–10%), but this difference was not significant (p = 0.620). Patients who were younger or had a higher education level or no history of delivery or shorter duration since diagnosis were prepared to accept higher additional risks of having no lymphadenectomy.

Conclusions

Our results show that the majority of endometrial cancer patients and clinicians will accept a small amount of recurrence risk to reduce the incidence of lymphedema. Regarding preference heterogeneity among patients, our results show that it is important for surgeons to take a patient-tailored approach when discussing surgical management.

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Acknowledgement

We thank all participating patients for their efforts. We extend our thanks to the KGOG members who participated in this survey. We also thank Soyeon Joo and Eunji Jung for their contribution in interviewing patients. Supported in part by a faculty research grant of Yonsei University College of Medicine for (6-2015-0074).

Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Institute of Women’s Life Medical Science, Yonsei University College of Medicine, Seoul, Korea

    Jung-Yun Lee MD, PhD, Eun Ji Nam MD, PhD, Sunghoon Kim MD, PhD, Sang Wun Kim MD, PhD & Young Tae Kim MD, PhD

  2. Korea Information Society Development Institute, Seoul, Chungcheongbuk-do, Korea

    Kyunghoon Kim PhD

  3. KAIST College of Business, Korea Advanced Institute of Science and Technology, Seoul, Korea

    Yun Shin Lee PhD & Hyo Young Kim MS

  4. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea

    Jae Weon Kim MD, PhD

Authors
  1. Jung-Yun Lee MD, PhD
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  2. Kyunghoon Kim PhD
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  3. Yun Shin Lee PhD
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  4. Hyo Young Kim MS
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  5. Eun Ji Nam MD, PhD
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  6. Sunghoon Kim MD, PhD
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  7. Sang Wun Kim MD, PhD
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  8. Jae Weon Kim MD, PhD
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  9. Young Tae Kim MD, PhD
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Corresponding author

Correspondence to Young Tae Kim MD, PhD.

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Lee, JY., Kim, K., Lee, Y.S. et al. Treatment Preferences for Routine Lymphadenectomy Versus No Lymphadenectomy in Early-Stage Endometrial Cancer. Ann Surg Oncol 24, 1336–1342 (2017). https://doi.org/10.1245/s10434-016-5729-7

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  • DOI: https://doi.org/10.1245/s10434-016-5729-7

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