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Decision Regret in Patients with Localised Prostate Cancer: A Systematic Review and Meta-analysis.

Jack B Fanshawe1, Vinson Wai-Shun Chan2, Aqua Asif3

  • 1Guy's and St Thomas' NHS Trust, London, UK.

European Urology Oncology
|March 4, 2023
PubMed
Summary
This summary is machine-generated.

One in five men with localised prostate cancer experience significant decision regret. Factors like poorer function and less involvement in treatment decisions increase regret, highlighting areas for improved patient care.

Keywords:
Decision regretPrognostic factorsProstate cancerQuality of life

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Area of Science:

  • Oncology
  • Health Services Research
  • Patient Psychology

Background:

  • Treatment decisions for localised prostate cancer present challenges, often leading to patient conflict and regret.
  • Understanding the prevalence and predictors of decision regret is crucial for enhancing patient quality of life.

Purpose of the Study:

  • To determine the prevalence of significant decision regret in localised prostate cancer patients.
  • To identify patient, oncological, and treatment factors associated with this regret.

Main Methods:

  • A systematic literature search was conducted across MEDLINE, Embase, and PsychINFO.
  • Pooled prevalence of significant regret was calculated, alongside an evaluation of prognostic factors from 14 studies involving 17,883 patients.

Main Results:

  • Significant decision regret was found in 20% of patients, with lower rates in active surveillance (13%) compared to radiotherapy (19%) or prostatectomy (18%).
  • Higher regret correlated with poorer post-treatment function (bowel, sexual, urinary), reduced involvement in decision-making, and Black ethnicity.
  • Evidence certainty for these factors was low to moderate.

Conclusions:

  • A substantial number of men experience decision regret following localised prostate cancer treatment.
  • Monitoring functional symptoms and enhancing patient involvement through education and decision aids may mitigate regret.