Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter Evaluation
Background: Several reports are available regarding the treatment decision regret of patients receiving conventional treatments for localized prostate cancer (PCa); yet data on patients undergoing focal therapy (FT) are sparse. Objective: To evaluate the treatment decision satisfaction and regret am...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-04-01
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| Series: | European Urology Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168323001064 |
| _version_ | 1827968082241388544 |
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| author | Alireza Ghoreifi Masatomo Kaneko Samuel Peretsman Atsuko Iwata Jessica Brooks Aliasger Shakir Dordaneh Sugano Jie Cai Giovanni Cacciamani Daniel Park Amir H. Lebastchi Osamu Ukimura Duke Bahn Inderbir Gill Andre Luis Abreu |
| author_facet | Alireza Ghoreifi Masatomo Kaneko Samuel Peretsman Atsuko Iwata Jessica Brooks Aliasger Shakir Dordaneh Sugano Jie Cai Giovanni Cacciamani Daniel Park Amir H. Lebastchi Osamu Ukimura Duke Bahn Inderbir Gill Andre Luis Abreu |
| author_sort | Alireza Ghoreifi |
| collection | DOAJ |
| description | Background: Several reports are available regarding the treatment decision regret of patients receiving conventional treatments for localized prostate cancer (PCa); yet data on patients undergoing focal therapy (FT) are sparse. Objective: To evaluate the treatment decision satisfaction and regret among patients who underwent FT for PCa with high-intensity focused ultrasound (HIFU) or cryoablation (CRYO). Design, setting, and participants: We identified consecutive patients who underwent HIFU or CRYO FT as the primary treatment for localized PCa at three US institutions. A survey with validated questionnaires, including the five-question Decision Regret Scale (DRS), International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF-5), was mailed to the patients. The regret score was calculated based on the five items of the DRS, and regret was defined as a DRS score of >25. Outcome measurements and statistical analysis: Multivariable logistic regression models were applied to assess the predictors of treatment decision regret. Results and limitations: Of 236 patients, 143 (61%) responded to the survey. Baseline characteristics were similar between responders and nonresponders. During a median (interquartile range) follow-up of 43 (26–68) mo, the treatment decision regret rate was 19.6%. On a multivariable analysis, higher prostate-specific antigen (PSA) at nadir after FT (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.1–2, p = 0.009), presence of PCa on follow-up biopsy (OR 3.98, 95% CI 1.5–10.6, p = 0.006), higher post-FT IPSS (OR 1.18, 95% CI 1.01–1.37, p = 0.03), and newly diagnosed impotence (OR 6.67, 95% CI 1.57–27, p = 0.03) were independent predictors of treatment regret. The type of energy treatment (HIFU/CRYO) was not a predictor of regret/satisfaction. Limitations include retrospective abstraction. Conclusions: FT for localized PCa is well accepted by the patients, with a low regret rate. Higher PSA at nadir, presence of cancer on follow-up biopsy, bothersome postoperative urinary symptoms, and impotence after FT were independent predictors of treatment decision regret. Patient summary: In this report, we looked at the factors affecting satisfaction and regret in patients with prostate cancer undergoing focal therapy. We found that focal therapy is well accepted by the patients, while presence of cancer on follow-up biopsy as well as bothersome urinary symptoms and sexual dysfunction can predict treatment decision regret. |
| first_indexed | 2024-04-09T18:15:40Z |
| format | Article |
| id | doaj.art-6ec36e56f4d54b8a89566ef0f2df7117 |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-04-09T18:15:40Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-6ec36e56f4d54b8a89566ef0f2df71172023-04-13T04:27:09ZengElsevierEuropean Urology Open Science2666-16832023-04-01501016Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter EvaluationAlireza Ghoreifi0Masatomo Kaneko1Samuel Peretsman2Atsuko Iwata3Jessica Brooks4Aliasger Shakir5Dordaneh Sugano6Jie Cai7Giovanni Cacciamani8Daniel Park9Amir H. Lebastchi10Osamu Ukimura11Duke Bahn12Inderbir Gill13Andre Luis Abreu14Center for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USA; Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanUrology Specialists of the Carolinas, Charlotte, NC, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USA; Department of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanUrology Specialists of the Carolinas, Charlotte, NC, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USA; Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USADepartment of Urology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, JapanProstate Institute of America, Ventura, CA, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USACenter for Image-Guided Surgery, Focal Therapy and Artificial Intelligence for Prostate Cancer, USC Institute of Urology, Los Angeles, CA, USA; Department of Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Corresponding author. Clinical Urology and Radiology, Institute of Urology, Norris Comprehensive Cancer Center, USC, 1441 Eastlake Ave, Suite 7416, Los Angeles, CA 90089-2211, USA. Tel. +1-323-865-3700; Fax: +1-323-865-0120.Background: Several reports are available regarding the treatment decision regret of patients receiving conventional treatments for localized prostate cancer (PCa); yet data on patients undergoing focal therapy (FT) are sparse. Objective: To evaluate the treatment decision satisfaction and regret among patients who underwent FT for PCa with high-intensity focused ultrasound (HIFU) or cryoablation (CRYO). Design, setting, and participants: We identified consecutive patients who underwent HIFU or CRYO FT as the primary treatment for localized PCa at three US institutions. A survey with validated questionnaires, including the five-question Decision Regret Scale (DRS), International Prostate Symptom Score (IPSS), and International Index of Erectile Function (IIEF-5), was mailed to the patients. The regret score was calculated based on the five items of the DRS, and regret was defined as a DRS score of >25. Outcome measurements and statistical analysis: Multivariable logistic regression models were applied to assess the predictors of treatment decision regret. Results and limitations: Of 236 patients, 143 (61%) responded to the survey. Baseline characteristics were similar between responders and nonresponders. During a median (interquartile range) follow-up of 43 (26–68) mo, the treatment decision regret rate was 19.6%. On a multivariable analysis, higher prostate-specific antigen (PSA) at nadir after FT (odds ratio [OR] 1.48, 95% confidence interval [CI] 1.1–2, p = 0.009), presence of PCa on follow-up biopsy (OR 3.98, 95% CI 1.5–10.6, p = 0.006), higher post-FT IPSS (OR 1.18, 95% CI 1.01–1.37, p = 0.03), and newly diagnosed impotence (OR 6.67, 95% CI 1.57–27, p = 0.03) were independent predictors of treatment regret. The type of energy treatment (HIFU/CRYO) was not a predictor of regret/satisfaction. Limitations include retrospective abstraction. Conclusions: FT for localized PCa is well accepted by the patients, with a low regret rate. Higher PSA at nadir, presence of cancer on follow-up biopsy, bothersome postoperative urinary symptoms, and impotence after FT were independent predictors of treatment decision regret. Patient summary: In this report, we looked at the factors affecting satisfaction and regret in patients with prostate cancer undergoing focal therapy. We found that focal therapy is well accepted by the patients, while presence of cancer on follow-up biopsy as well as bothersome urinary symptoms and sexual dysfunction can predict treatment decision regret.http://www.sciencedirect.com/science/article/pii/S2666168323001064Focal therapyPatient satisfactionProstate cancerOutcome |
| spellingShingle | Alireza Ghoreifi Masatomo Kaneko Samuel Peretsman Atsuko Iwata Jessica Brooks Aliasger Shakir Dordaneh Sugano Jie Cai Giovanni Cacciamani Daniel Park Amir H. Lebastchi Osamu Ukimura Duke Bahn Inderbir Gill Andre Luis Abreu Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter Evaluation European Urology Open Science Focal therapy Patient satisfaction Prostate cancer Outcome |
| title | Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter Evaluation |
| title_full | Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter Evaluation |
| title_fullStr | Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter Evaluation |
| title_full_unstemmed | Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter Evaluation |
| title_short | Patient-reported Satisfaction and Regret Following Focal Therapy for Prostate Cancer: A Prospective Multicenter Evaluation |
| title_sort | patient reported satisfaction and regret following focal therapy for prostate cancer a prospective multicenter evaluation |
| topic | Focal therapy Patient satisfaction Prostate cancer Outcome |
| url | http://www.sciencedirect.com/science/article/pii/S2666168323001064 |
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