Patients' Preferences for Gastric Cancer Treatment: A Cross-Sectional Study on Decision-Making in Multidisciplinary Treatment Strategies

Abstract

Purpose: Decisions regarding gastric cancer treatment affect patient outcomes and quality of life (QOL); nonetheless, factors influencing patient preferences remain unclear. This study investigated the preferences for the extent of gastrectomy, minimally invasive surgery, and adjuvant therapy while identifying the key determinants. Materials and Methods: A cross-sectional survey of 240 respondents, including patients with gastric cancer and the general population, assessed their preferences for the extent of gastrectomy, surgical modality, adjuvant therapy, palliative systemic therapy, and endoscopic therapy. Correlations between demographic variables and treatment choices were statistically analyzed. Results: Patients prioritized expert recommendations for determining the extent of gastrectomy for proximal gastric cancer and selecting the surgical modality, with recurrence risk and surgical complications being the primary considerations. In terms of adjuvant therapy, a 12-month oral regimen was preferred over a 6-month oral plus injection regimen, with survival benefit being the most valued factor. Conversely, QOL was a primary concern in palliative therapy. With respect to incomplete endoscopic submucosal dissection, electrocauterization was the preferred approach, followed by surgical resection; local recurrence risk was assigned with the highest priority, followed by concerns regarding lymph node metastasis. Men and individuals living alone had a lower risk of recurrence and lymph node metastasis. Patients undergoing gastric cancer treatment preferred shorter procedures, whereas medical personnel emphasized surgical safety and efficiency. Conclusions: Demographic and clinical factors significantly influence patient preferences. Understanding these preferences is essential for shared decision-making and personalized oncological care.