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Treatment Decision Regret in Long-Term Prostate Cancer Survivors After Radical Prostatectomy
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Decisional regret may develop over time as patients reflect on the outcomes of their treatment decision. This study investigated the prevalence and predictors of longitudinal decisional regret among more than 1000 prostate cancer survivors treated with radical prostatectomy from a German database. The patients completed quality-of-life questionnaires during the long-term follow-up. The study found that the rate of patients experiencing decisional regret increased significantly from 9% in 2007 (after a median follow-up period of 6.9 years) to 12% in 2020 (after a median follow-up period of 19 years). Decisional regret was associated with favorable localized prostate cancer and higher depression scores. Patients who reported shared decision–making were less likely to experience decisional regret.
- This longitudinal study involving patients undergoing prostatectomy showed that shared decision–making was protective against regret and that patients with higher depression scores were more likely to have regret.
abstract
This abstract is available on the publisher's site.
Access this abstract nowOBJECTIVES
To investigate prevalence, course, and predictors of longitudinal decision regret in long-term prostate cancer (PC) survivors treated by radical prostatectomy (RP).
PATIENTS AND METHODS
1003 PC survivors from the multicentre German Familial PC Database completed questionnaires on average seven years after RP in 2007 and at follow-up 13 years later in 2020. Patients completed standardized patient-reported outcome measures on decision regret, decision-making, HRQoL, and psychosocial factors. Hierarchical multivariable logistic regression was used to assess predictors of longitudinal decision regret.
RESULTS
Decision regret increased significantly over time (9.0% after 6.9 years in 2007 and 12% after 19 years in 2020; p=0.009). Favourable localized PC (OR 1.97, 95% CI 1.05-3.68), decision regret in 2007 (OR: 6.38, 95% CI 3.55-11.47), and a higher depression score (OR 1.37 95% CI 1.03-1.83) were associated with decision regret in 2020. Shared decision-making (OR: 0.55, 95% CI 0.33-0.93) was associated with less decision regret.
CONCLUSION
Findings of the present study underline the perseverance of decision regret in long-term PC survivors and the definitive need for involving patients in the decision-making process to mitigate regret over the long term.
Additional Info
Disclosure statements are available on the authors' profiles:
Treatment decision regret in long-term survivors after radical prostatectomy: a longitudinal study
BJU Int 2022 Dec 22;[EPub Ahead of Print], VH Meissner, BW Simson, A Dinkel, S Schiele, DP Ankerst, L Lunger, JE Gschwend, K HerkommerFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
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