Skip to main content
SSO 2024 Annual Meeting Main banner
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
Recorded for On-Demand Viewing
Recorded for On-Demand Viewing
Back

Quality Improvement/Clinical Outcomes

E386: Patient-Reported Outcome Measures in Surgical Patients with Upper Gastrointestinal Cancers: A Qualitative Interview Study

    ePoster Abstract Author(s)

  • Samuel H. Cass, MD

    Research Resident
    The University of Texas MD Anderson Cancer Center
    Dickinson, Texas, United States

    • Submitter(s)

  • Samuel H. Cass, MD

    Research Resident
    The University of Texas MD Anderson Cancer Center
    Dickinson, Texas, United States

    • Author(s)

  • Samuel H. Cass, MD

    Research Resident
    The University of Texas MD Anderson Cancer Center
    Dickinson, Texas, United States

  • LW

    Loretta Williams, PhD

    Assistant Professor
    MD Anderson Cancer Center, United States

  • Naruhiko Ikoma, MD, MS

    Assistant Professor of Surgical Oncology
    The University of Texas MD Anderson Cancer Center
    Houston, Texas, United States

  • XW

    Xin Shelley Wang, MD, MPH

    Professor
    MD Anderson Cancer Center, United States

Introduction:

Patients with pancreatic and gastroesophageal (PGE) cancers experience high symptom burden but patient experience throughout multimodality treatment remains unclear. Surgical patients with PGE cancers often suffer unique postsurgical symptoms. The core MD Anderson Symptom Inventory (MDASI-Core) is a patient-reported outcome (PRO) assessment tool which has been validated in multiple cancer types to assess symptoms related to cancer treatment, yet a measurement tool specific for surgical patients with PGE cancer has yet to be developed. We therefore aimed to delineate the experience and symptom burden of patients through therapy, surgery, and postoperative recovery.

Methods: Qualitative interviews were performed with patients with PGE cancer who had undergone surgical resection until thematic saturation was achieved. Patients described their symptoms associated with PGE cancer as well as with their treatment and surgery. Reported symptoms were summarized by frequency. An expert panel of surgeons,  patients, and caregivers then assessed the relevance of these symptom items. Symptom items were selected for future psychometric validation based on one of three reasons: 1) symptom was one of 13 core MDASI items that have been extensively validated; 2) symptom was mentioned by > 20% of participants in qualitative interviews; 3) the item received a mean relevancy ranking > 3 (relevant to very relevant) by the expert panel.

Results: Thematic saturation was achieved after the 17th qualitative interview. Of those 17 patients, 35% (n=6) underwent gastrectomy, 30% (n=5) underwent esophagectomy, and 35% (n=6) underwent pancreatectomy; 76% (n=13) received neoadjuvant therapy. Among them, a total of 32 symptom items were reported, and 19 symptom items were reported by over 20% of the patients. Although severity varied, we observed significant overlap of reported symptom items from cohorts with different disease sites, assuring the validity of developing a common questionnaire for patients with PGE cancers undergoing surgery. A panel of 19 experts then rated 7 symptoms to be relevant to patients with PGE patients. Among those, 9 were not included in MDASI-Core, thus added to compose a total of 22 symptom items for further psychometric validation (Table 1).

Conclusions: We developed a provisional symptom inventory with the intention to be used for assessing longitudinal changes in symptom burden for surgical patients with PGE cancer throughout their multidisciplinary treatment. This symptom inventory module will be psychometrically validated in an upcoming study.

Learning Objectives:

  • Upon completion, participant will be able to understand the value of qualitative interview studies for the development of patient-reported outcome assessment tools.
  • Upon completion, participant will be able to understand the methodology of PRO assessment tool development, starting with interviews, relevancy rating, and psychometric validation.
  • Upon completion, participant will be able to understand the common symptom items reported among surgical patients following multidisciplinary treatment for upper gastrointestinal cancers.