Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2023 Aug 23;23(1):139.
doi: 10.1186/s12894-023-01311-9.

Prevalence and determinants of decision regret in long-term prostate cancer survivors following radical prostatectomy

Lukas Lunger  1 , Valentin H Meissner  1 , Benedikt C G Kopp  1 , Andreas Dinkel  2 , Stefan Schiele  1 , Donna P Ankerst  3 , Jürgen E Gschwend  1 , Kathleen Herkommer  4
Affiliations
Multicenter Study

Prevalence and determinants of decision regret in long-term prostate cancer survivors following radical prostatectomy

Lukas Lunger et al. BMC Urol. .

Abstract

Background: Patients with localized prostate cancer (PC) are faced with a wide spectrum of therapeutic options at initial diagnosis. Following radical prostatectomy (RP), PC patients may experience regret regarding their initial choice of treatment, especially when oncological and functional outcomes are poor. Impacts of psychosocial factors on decision regret, especially after long-term follow-up, are not well understood. This study aimed to investigate the prevalence and determinants of decision regret in long-term PC survivors following RP.

Methods: 3408 PC survivors (mean age 78.8 years, SD = 6.5) from the multicenter German Familial PC Database returned questionnaires after an average of 16.5 (SD = 3.8) years following RP. The outcome of decision regret concerning the initial choice of RP was assessed with one item from the Decision Regret Scale. Health-related quality of life (HRQoL), PC-anxiety, PSA-anxiety, as well as anxiety and depressive symptoms were considered for independent association with decision regret via multivariable logistic regression.

Results: 10.9% (373/3408) of PC survivors reported decision regret. Organ-confined disease at RP (OR 1.39, 95%CI 1.02-1.91), biochemical recurrence (OR 1.34, 1.00-1.80), low HRQoL (OR 1.69,1.28-2.24), depressive symptoms (OR 2.32, 1.52-3.53), and prevalent PSA anxiety (OR 1.88,1.17-3.01) were significantly associated with increased risk of decision regret. Shared decision-making reduced the odds of decision regret by 40% (OR 0.59, 0.41-0.86).

Conclusions: PC survivors may experience decision regret even after 16 years following RP. Promoting shared decision-making in light of both established and novel, potentially less invasive treatments at initial diagnosis may help mitigate long-term regret. Awareness regarding patients showing depressive symptoms or PSA anxiety should be encouraged to identify patients at risk of decision regret in need of additional psychological support.

Keywords: Decision regret; Depression; PSA-anxiety; Prostate cancer-related anxiety; Radical prostatectomy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Forest plot to illustrate multivariable logistic regression analyses carried out to determine the association of selected sociodemographic, clinicopathological, and psychological characteristics with decision regret Abbreviations: RP = radical prostatectomy. HRQoL = Health related quality of life. PC = prostate cancer. PSA = prostate specific antigen
See this image and copyright information in PMC

References

    1. EAU-ESTRO-SIOG Guidelines. on Prostate Cancer [https://d56bochluxqnz.cloudfront.net/documents/full-guideline/EAU-EANM-E...]
    1. Morris BB, Farnan L, Song L, Addington EL, Chen RC, Nielsen ME, Mishel M, Mohler JL, Bensen JT. Treatment decisional regret among men with prostate cancer: racial differences and influential factors in the North Carolina Health Access and prostate Cancer Treatment Project (HCaP-NC) Cancer. 2015;121(12):2029–35. doi: 10.1002/cncr.29309. - DOI - PubMed
    1. Wilding S, Downing A, Selby P, Cross W, Wright P, Watson EK, Wagland R, Kind P, Donnelly DW, Hounsome L, et al. Decision regret in men living with and beyond nonmetastatic prostate cancer in the United Kingdom: a population-based patient-reported outcome study. Psychooncology. 2020;29(5):886–93. doi: 10.1002/pon.5362. - DOI - PMC - PubMed
    1. Hoffman RM, Lo M, Clark JA, Albertsen PC, Barry MJ, Goodman M, Penson DF, Stanford JL, Stroup AM, Hamilton AS. Treatment decision regret among long-term survivors of localized prostate Cancer: results from the prostate Cancer Outcomes Study. J Clin Oncol. 2017;35(20):2306–14. doi: 10.1200/JCO.2016.70.6317. - DOI - PMC - PubMed
    1. Wallis CJD, Zhao Z, Huang LC, Penson DF, Koyama T, Kaplan SH, Greenfield S, Luckenbaugh AN, Klaassen Z, Conwill R, et al. Association of Treatment Modality, Functional Outcomes, and baseline characteristics with treatment-related regret among men with localized prostate Cancer. JAMA Oncol. 2022;8(1):50–9. doi: 10.1001/jamaoncol.2021.5160. - DOI - PMC - PubMed

Publication types

Substances