Pre-treatment expectations of patients with spinal metastases: what do we know and what can we learn from other disciplines? A systematic review of qualitative studies

• Published in: BMC cancer 2020-12, Vol.20 (1), p.1212-1212, Article 1212
• Main Authors: Gal, R, Oostinga, D, Wessels, H, Verlaan, J J, Charest-Morin, R, Fisher, C G, Verkooijen, H M, Versteeg, A L
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Advanced cancer; Aged; Anticipation, Psychological; Back pain; Back surgery; Cancer; Cancer patients; Care and treatment; Clinical outcomes; Counseling; Credibility; Female; Humans; Male; Metastases; Metastasis; Middle Aged; Motivation; Neurosurgical Procedures - psychology; Oncology, Experimental; Pain; Pain - etiology; Pain - psychology; Patient expectations; Patient satisfaction; Patients; Patients - psychology; Prognosis; Psychological aspects; Qualitative Research; Quality of Life; Radiation therapy; Radiotherapy - psychology; Recovery of Function; Socioeconomic Factors; Spinal diseases; Spinal metastases; Spinal Neoplasms - psychology; Spinal Neoplasms - radiotherapy; Spinal Neoplasms - secondary; Spinal Neoplasms - surgery; Spine surgery; Surgeons; Surgery; Systematic review; Treatment Outcome; Treatment outcomes
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/s12885-020-07683-7

Little is known about treatment expectations of patients with spinal metastases undergoing radiotherapy and/or surgery. Assuming that patients with spinal metastases share characteristics with patients who had spinal surgery for non-cancer related conditions and with advanced cancer patients, we performed a systematic review to summarize the literature on patient expectations regarding treatment outcomes of spinal surgery and advanced cancer care. A comprehensive search was performed in MEDLINE, EMBASE and PsycINFO for studies between 2000 and sep-2019. Studies including adult patients (> 18 years), undergoing spinal surgery or receiving advanced cancer care, investigating patients' pre-treatment expectations regarding treatment outcomes were included. Two independent reviewers screened titles, abstracts and full-texts, extracted data and assessed methodological quality. The search identified 7343 articles, of which 92 were selected for full-text review. For this review, 31 articles were included. Patients undergoing spinal surgery had overly optimistic expectations regarding pain and symptom relief, they underestimated the probability of functional disability, and overestimated the probability of (complete) recovery and return to work. Studies highlighted that patients feel not adequately prepared for surgery in terms of post-treatment expectations. Similarly, advanced cancer patients receiving palliative treatment often had overly optimistic expectations regarding their survival probability and cure rates. Patients tend to have overly optimistic expectations regarding pain and symptom relief, recovery and prognosis following spinal surgery or advanced cancer care. Pretreatment consultation about the expected pain and symptom relief, recovery and prognosis may improve understanding of prognosis, and promote and manage expectations, which, in turn, may lead to better perceived outcomes. PROSPERO registration number: CRD42020145151 .