Association of Patient Comorbidities with Treatment Regret Among Patients with Localized Prostate Cancer - Results from a Population-Based Cohort.

IF 3.5 3区医学 Q2 ONCOLOGY

Practical Radiation Oncology Pub Date : 2025-08-30 DOI:10.1016/j.prro.2025.07.007

Rahul D Mali, Ying Cao, Aaron J Katz, Katelyn Kane, Yahui Xie, Deborah S Usinger, Xinglei Shen, Ronald C Chen

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引用次数: 0

Abstract

Objectives: Decision regret is a well-established, negative outcome in prostate cancer. We hypothesized that baseline comorbidities, which impact treatment tolerability, are associated with regret.

Materials and methods: In a prospective, population-based cohort of prostate cancer patients, patient-reported regret was assessed at 12 months after treatment using a validated measure. Comorbidities were assessed using medical record abstraction and scored using the validated NCI Comorbidity Index. Multivariable logistic regression assessed the association between comorbidity score with regret, accounting for treatment-related symptoms, treatment received, and sociodemographic measures.

Results: This is a diverse cohort with 25.3% Black and 24.2% living in rural areas. A total of 108 out of 981 patients (11%) reported regret. On multivariable analysis, comorbidity burden (OR 1.58, p<.05), not married (OR 1.72, p=.04), worsening of bowel symptoms (OR 2.12, p<.01) and worsening of urinary obstruction/irritation (OR 1.60, p=.05) were associated with decision regret. In addition, radiation therapy was associated with less regret compared to radical prostatectomy (OR 0.48, p=.015).

Conclusion: Among men with localized prostate cancer, baseline comorbidity burden is associated with increased decision regret. These results illustrate the importance of assessing baseline comorbidities and incorporation of its consideration in the treatment decision-making process, to ensure that patients have realistic expectations and make an informed decision.

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局限性前列腺癌患者合并症与治疗后悔的关系——基于人群的队列研究结果

目的：决策后悔是前列腺癌的一个公认的阴性结果。我们假设影响治疗耐受性的基线合并症与后悔有关。材料和方法：在一项前瞻性的、以人群为基础的前列腺癌患者队列研究中，采用一种有效的测量方法，在治疗后12个月评估患者报告的后悔。使用病历摘要评估合并症，并使用经过验证的NCI合并症指数评分。多变量逻辑回归评估了共病评分与后悔、治疗相关症状、接受治疗和社会人口学测量之间的关系。结果：这是一个多样化的队列，其中25.3%是黑人，24.2%生活在农村地区。981名患者中有108名（11%）表示后悔。结论：在局限性前列腺癌患者中，基线共病负担与决策后悔增加相关。这些结果说明了评估基线合并症并将其纳入治疗决策过程的重要性，以确保患者有现实的期望并做出明智的决定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

6.10%

发文量

177

审稿时长

34 days

期刊介绍： The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.