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Colorectal cancer and synchronous liver metastases : an individual case-based qualitative study (CoSMIC-Q)
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Chan, Anthony K. C., Ignatowicz, Agnieszka M., Mason, James and Siriwardena, Ajith K. (2022) Colorectal cancer and synchronous liver metastases : an individual case-based qualitative study (CoSMIC-Q). European Journal of Surgical Oncology (EJSO), 48 (8). pp. 1815-1822. doi:10.1016/j.ejso.2022.04.008 ISSN 0748-7983.
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WRAP-Colorectal-cancer-synchronous-liver-metastases-individual-CoSMIC-Q-2022.pdf - Accepted Version - Requires a PDF viewer. Available under License Creative Commons Attribution Non-commercial No Derivatives 4.0. Download (378Kb) | Preview |
Official URL: http://dx.doi.org/10.1016/j.ejso.2022.04.008
Abstract
Background
Contemporary management of colorectal cancer with synchronous liver metastases is complex. Although there is a large body of cohort data, there is no research exploring patient and clinician perspectives. This study explores the experiences and views of patients following treatment for colorectal cancer with synchronous liver metastases and the clinicians involved in their care.
Methods
This is a qualitative study based on interviews with patients who had completed treatment for colorectal cancer with synchronous liver metastases and their treating clinicians. The interviews were recorded, transcribed and analysed using thematic analysis methods. Codes were developed both horizontally regarding each interview as a standalone hermeneutic unit and vertically by scanning across interviews for specific terms.
Results
Four overarching themes emerged: patients’ experience of initial diagnosis, involvement in treatment, views on the order of staged resections and views about research. For patients, the first consultation is critically important. Patients generally perceived sufficient autonomy in decision-making. In treatment options there is a preference for synchronous surgery balanced by an understanding of the greater risk. Patients did not want liver-first surgery due to the perceived risk of continued seeding from an in situ primary tumour. Clinicians accepted limited evidence for decision making but felt that trials of treatment sequencing were not feasible.
Conclusions
This first qualitative study explores patients' perceptions in colorectal cancer with synchronous liver metastases that are not possible to obtain from quantitative data. CoSMIC-Q demonstrates the importance of incorporating patients’ views into treatment planning particularly where equipoise exists in surgical sequence.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RC Internal medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Colon (Anatomy) -- Cancer, Liver metastasis, Colon (Anatomy) -- Cancer -- Patients -- Interviews, Liver metastasis -- Patients -- Interviews, Colon (Anatomy) -- Cancer -- Treatment, Colon (Anatomy) -- Cancer -- Diagnosis | ||||||||
Journal or Publication Title: | European Journal of Surgical Oncology (EJSO) | ||||||||
Publisher: | W.B. Saunders Co. Ltd. | ||||||||
ISSN: | 0748-7983 | ||||||||
Official Date: | August 2022 | ||||||||
Dates: |
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Volume: | 48 | ||||||||
Number: | 8 | ||||||||
Page Range: | pp. 1815-1822 | ||||||||
DOI: | 10.1016/j.ejso.2022.04.008 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Copyright Holders: | © 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved. | ||||||||
Date of first compliant deposit: | 22 April 2022 | ||||||||
Date of first compliant Open Access: | 14 April 2023 | ||||||||
RIOXX Funder/Project Grant: |
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