February 10, 2020 - Men with localized prostate cancer are faced with deciding among a range of options for treatment - including a choice between robot-assisted versus conventional prostatectomy. A new follow-up study in The Journal of Urology® finds that most patients choosing surgery for prostate cancer don't regret their decisions. The Journal of Urology®, Official Journal of the American Urological Association (AUA), is published in the Lippincott portfolio by Wolters Kluwer.
Patients who play a more active role in making decisions about prostate cancer surgery are less likely to experience "decision regret" about their choices, according to the new research by Johannes Huber, MD, PhD, of Technische Universität Dresden, Germany, and colleagues. The study also finds no difference in decision regret in men opting for open versus robot-assisted surgery.
Study Looks at Decision Regret after Prostate Cancer Surgery
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The study included data from a large-scale German healthcare research project, called HAROW, that analyzed outcomes for men choosing different treatments for localized prostate cancer - meaning that the cancer hasn't spread beyond the prostate gland. "The name HAROW refers to the major treatment options for patients with this diagnosis - namely hormone therapy, active surveillance, radiation, operation (surgery), or watchful waiting," explains study coauthor Dr. Lothar Weissbach, founder of the HAROW project.
In recent years, robot-assisted prostatectomy has become an increasingly popular alternative to conventional open surgery. While the robot-assisted procedure may enable faster recovery, studies have shown "no definite advantage" in terms of prostate cancer outcomes.
Few studies have looked at decision regret by men choosing among prostate cancer treatments. "Decision related regret is a negative emotion associated with thinking about a past choice and comparing the status quo with a hypothetical situation which might have taken place with having chosen a different treatment alternative," Dr. Huber and coauthors explain.
The authors analyzed decision regret in 936 men who underwent prostate cancer surgery, of whom 532 underwent open prostate surgery and 404 underwent robot-assisted surgery. At follow-up of about six years, patients rated their "distress or remorse" about their treatment choice using a 0 to 100 Decision Regret Scale (with 100 being the highest level of regret).