ArticleAnnals of surgical oncology2026
Decision-Making and Decision Satisfaction Following Cytoreductive Surgery and HIPEC for GI Malignancies: A Qualitative Study.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
background and purposeFor patients with aggressive gastrointestinal malignancies, cytoreductive surgery and heated intraperitoneal chemotherapy (CRS/HIPEC) offers a chance for prolonged survival but comes with risks of morbidity, decreased quality of life, and-rarely-death. Decision-making for patients considering CRS/HIPEC is complex and understudied. This study explored how patients approached the decision to pursue CRS/HIPEC and how they perceived their decisions postoperatively.
methodsWe performed a qualitative study with patients who underwent CRS/HIPEC between May 2023 and March 2024. Patients were interviewed using a semi-structured interview guide focused on understanding the decision-making process around CRS/HIPEC and assessing whether patients experienced decision regret after surgery. Transcripts were analyzed inductively using the constant comparative method.
resultsIn total, 14 of 18 patients completed interviews at a median of 16.9 months after CRS/HIPEC (median age 57 years; 50% women). We identified four key themes, which focused on patient sources of information about CRS/HIPEC, preoperative conversations about CRS/HIPEC, the decision-making-process, and decision satisfaction versus decision regret. Most patients felt they had little agency in the decision to pursue CRS/HIPEC but were trusting of their providers' recommendations. Decision regret was uncommon and most associated with recurrent disease when present. Patients placed high value on their disease-free interval and time away from chemotherapy. DISCUSSION: This study offers an improved understanding of the decision-making process for patients pursuing CRS/HIPEC. Surgeons can use these data to improve preoperative counselling. Future quality-of-life studies should include questions to determine the value of chemotherapy-free intervals.
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