Table 3 Differences in the treatment conditions, medications, and treatment strategies among different levels of hospitals
Questions | Answers | Tertiary first-class hospital (n = 571) | Tertiary hospital (n = 185) | Secondary and lower hospital (n = 265) | P-value |
|---|---|---|---|---|---|
Treatment conditions | |||||
Is the price of medication acceptable? | Yes | 398 (69.7%) | 148 (80.0%) | 188 (70.9%) | 0.024* |
No | 173 (30.3%) | 37 (20.0%) | 77 (29.1%) | ||
Are drugs sufficient? | Yes | 146 (25.6%) | 32 (17.3%) | 72 (27.2%) | 0.038* |
No | 425 (74.4%) | 153 (82.7%) | 193 (72.8%) | ||
What is your major drug source? | Imported | 188(32.9%) | 66(35.7%) | 84(31.7%) | 0.240 |
Domestic | 306(53.6%) | 93(50.3%) | 130(49.1%) | ||
Available | 77(13.5%) | 26(14.1%) | 51(19.2%) | ||
What is the percentage of the advanced stage cancer in your practice? | < 40% | 165 (28.9%) | 48 (25.9%) | 87 (32.8%) | 0.315 |
40–60% | 222 (38.9%) | 77 (41.6%) | 87 (32.8%) | ||
> 60% | 184 (32.2%) | 60 (32.4%) | 91 (34.3%) | ||
What is the percentage of first diagnosis? | < 20% | 289 (50.6%) | 94 (50.8%) | 157 (59.2%) | 0.058 |
20–40% | 161 (28.2%) | 58 (31.4%) | 72 (27.2%) | ||
> 40% | 121 (21.2%) | 33 (17.8%) | 36 (13.6) | ||
Is the method of diagnosis enough? | Yes | 290 (50.8%) | 81 (43.8%) | 142 (53.6%) | 0.114 |
No | 281 (49.2%) | 104 (56.2%) | 123 (46.4%) | ||
Is your hospital able to conduct further tests to determine the nature of the liver masses? | Yes | 564 (98.8%) | 180 (97.3%) | 237 (89.4%) | <0.001* |
No | 7 (1.2%) | 5 (2.7%) | 28 (10.6%) | ||
Medication methods | |||||
Do you advocate traditional Chinese medicine? | Yes | 330 (57.8%) | 115 (62.2%) | 189 (71.3%) | <0.001* |
No | 241 (42.2%) | 70 (37.8%) | 76 (28.7%) | ||
What is your preferred immunotherapy drug? | PD-1 | 445 (77.9%) | 134 (72.4%) | 194 (73.2%) | 0.253 |
PD-L1 | 106 (18.6%) | 41 (22.2%) | 63 (23.8%) | ||
CTLA-4 | 20 (3.5%) | 10 (5.4%) | 8 (3.0%) | ||
How do you deal with adverse effects of targeted therapy? | Keeping the dosage and frequency | 197(34.5%) | 72(38.9%) | 87(32.8%) | 0.020* |
Reducing the dosage | 307(53.8%) | 97(52.4%) | 129(48.7%) | ||
Intermittent medication | 67(11.7%) | 16(8.6%) | 49(18.5%) | ||
What is your preferred targeted drug? | Sorafenib | 326 (57.1%) | 102 (55.1%) | 144 (54.3%) | <0.001* |
Lenvatinib | 209 (36.6%) | 56 (30.3%) | 79 (29.8%) | ||
Second-line drugs | 36 (6.3%) | 27 (14.6%) | 42 (15.8%) | ||
Treatment strategies | |||||
What are your major considerations for prescribing? | Cost or insurance | 199 (34.9%) | 68 (36.8%) | 93 (35.1%) | 0.766 |
Effectiveness | 285 (49.9%) | 84 (45.4%) | 125(47.2%) | ||
Availability | 87(15.2%) | 33(17.8%) | 47(17.7%) | ||
What is your preferred treatment regimen? | Targeted therapy | 58(10.2%) | 20(10.8%) | 36(13.6%) | 0.400 |
Immunotherapy | 8(1.4%) | 3(1.6%) | 1(0.4%) | ||
Target therapy & Immunotherapy | 489(85.6%) | 157(84.9%) | 225(84.9%) | ||
Chemotherapy | 16(2.8%) | 5(2.7%) | 3(1.1%) | ||
Do you support the disclosure of the patients’ true conditions? | Yes | 382(66.9%) | 110(59.5%) | 140(52.8%) | <0.001* |
No | 189(33.1%) | 75(40.5%) | 125(47.2%) | ||
Who will make the final decisions on treatment? | Doctors | 84(14.7%) | 22(11.9%) | 35(13.2%) | 0.555 |
Patients | 129(22.6%) | 52(28.1%) | 61(23.0%) | ||
Patients’ family | 358(62.7%) | 111(60.0%) | 169(63.8%) | ||
Is the pathological diagnosis important? | Yes | 285(49.9%) | 100(54.1%) | 134(50.6%) | 0.616 |
No | 286(50.1%) | 85(45.9%) | 131(49.4%) | ||
What is your recommended hospital when the diagnosis is vague? | Local hospitals | 65 (11.4%) | 27 (14.6%) | 61 (23.0%) | <0.001* |
Provincial capital hospitals | 199 (34.9%) | 109 (58.9%) | 154 (58.1%) | ||
National top hospitals | 307 (53.8%) | 49 (26.5%) | 50 (18.9%) |