Low conflict and high satisfaction: Decisional outcomes after attending a combined clinic to choose between robotic prostatectomy and radiotherapy for prostate cancer

Published on Jun 8, 2021in Urologic Oncology-seminars and Original Investigations2.882
· DOI :10.1016/J.UROLONC.2021.05.007
Allan Ben Smith17
Estimated H-index: 17
(UNSW: University of New South Wales),
Orlando Rincones3
Estimated H-index: 3
(UNSW: University of New South Wales)
+ 7 AuthorsAfaf Girgis67
Estimated H-index: 67
(UNSW: University of New South Wales)
Abstract null null Background null Decisional conflict and post-treatment decisional regret have been documented in men with localised prostate cancer (LPC). However, there is limited evidence regarding decisional outcomes associated with the choice between robotic-assisted radical prostatectomy (RARP) and radiotherapy, when both treatment options are available in the public health system. There is increasing support for multidisciplinary approaches to guide men with LPC in their decision-making process. This study assessed decisional outcomes in men deciding between RARP or radiotherapy treatment before and after attending a LPC combined clinic (CC). null null null Methods null Quantitative longitudinal data were collected from 52 men who attended a LPC CC, where they saw both a urologist and radiation oncologist. Patients completed questionnaires assessing involvement in decision-making, decisional conflict, satisfaction and regret before and after the CC, three months, six months and 12 months post-treatment. Urologists and radiation oncologists also reported their perceptions regarding patients' suitability for, openness to, perceived preferences and appropriateness for each treatment. Data was analysed using paired/independent samples t-tests and McNemar's tests. null null null Results null Most participants (n = 37, 71%) opted for RARP over radiotherapy (n = 14, 27%); one participant deferred treatment (2%). Urologists and radiation oncologists reported low agreement (κ = 0.26) regarding the most appropriate treatment for each patient. Participants reported a desire for high levels of control over their decision-making process (77.5% patient-led, 22.5% shared) and high levels of decisional satisfaction (M = 4.4, SD = 0.47) after the CC. Decisional conflict levels were significantly reduced (baseline: M = 29.3, SD = 16.9, post-CC: M = 16.3, SD = 11.5; t = 5.37, P null null null null Conclusion null This is the first Australian study to assess decisional outcomes when patients are offered the choice between RARP and radiotherapy in the public health system. A CC seems to support decision-making in men with LPC and positively impact some decisional outcomes. However, larger-scale controlled studies are needed to confirm these findings.
📖 Papers frequently viewed together
10 Citations
7 Authors (C. Chabrera, ..., Albert Font)
43 Citations
#1Lindsay Jamie (Royal Surrey County Hospital)
#1Jamie Stephen Lindsay (Royal Surrey County Hospital)
Last. Venkata R.M. Kusuma (Royal Surrey County Hospital)H-Index: 2
view all 7 authors...
Abstract OBJECTIVE To assess treatment satisfaction and decision regret post robot-assisted radical prostatectomy (RARP) and correlate these with clinical, demographic and quality of life indicators. Our study took place at a high-volume UK centre and patients were assessed at a minimum of 18 months post-surgery. METHODS Patients who underwent RARP between June 2011 and May 2016 were invited to participate through mailed questionnaires. A total of 207 patients formed our cohort. The questionnair...
4 CitationsSource
#1Leilei Xia (UPenn: University of Pennsylvania)H-Index: 14
#2Colin D. Sperling (UPenn: University of Pennsylvania)H-Index: 4
Last. Thomas J. Guzzo (UPenn: University of Pennsylvania)H-Index: 32
view all 9 authors...
Introduction:Robot-assisted radical prostatectomy (RARP) has become the predominant surgical modality to manage localized prostate cancer in the US. However, there are very few studies focusing on ...
7 CitationsSource
#1Martin Baunacke (TUD: Dresden University of Technology)H-Index: 8
#2Maria-Luisa Schmidt (TUD: Dresden University of Technology)H-Index: 2
Last. Johannes Huber (TUD: Dresden University of Technology)H-Index: 18
view all 10 authors...
Introduction:Numerous studies have compared outcomes of open (ORP) and robotic-assisted radical prostatectomy (RARP), but only one study focused on patient satisfaction and regret. Our study aimed ...
11 CitationsSource
#1Sarah Wilding (University of Leeds)H-Index: 7
#2Amy Downing (University of Leeds)H-Index: 23
Last. Adam Glaser (University of Leeds)H-Index: 33
view all 16 authors...
OBJECTIVE: Clinical options for managing nonmetastatic prostate cancer (PCa) vary. Each option has side effects associated with it, leading to difficulty in decision-making. This study aimed to assess the relationship between patient involvement in treatment decision-making and subsequent decision regret (DR), and quantify the impact of health-related quality of life (HRQL) outcomes on DR. METHODS: Men living in the United Kingdom, 18 to 42 months after diagnosis of PCa, were identified from can...
6 CitationsSource
#1Marie-Anne van Stam (UU: Utrecht University)H-Index: 5
#2Neil K. Aaronson (NKI-AVL: Netherlands Cancer Institute)H-Index: 128
Last. Henk G. van der Poel (NKI-AVL: Netherlands Cancer Institute)H-Index: 56
view all 8 authors...
Abstract Background Well-documented reports of patients' experiences with different treatments are important for helping localised prostate cancer (LPC) patients choose among the available treatment options. Objective To document differences in patient-reported outcomes (PROs) following radical prostatectomy (RP), external beam radiotherapy (EBRT), brachytherapy (BT), and active surveillance (AS), and to evaluate how these PROs and other factors are associated with treatment decision regret. Des...
22 CitationsSource
The diagnosis of prostate cancer (PCa) often represents a stressful event. In addition to the psychological distress related to the diagnosis, patients face challenging health decisions: in fact, besides radical treatments, Active Surveillance may represent an option for patients with diagnosis of localized PCa. A multidisciplinary clinical approach seems to represent the suitable organizational model to meet such a requirement, optimising the therapeutic outcome for PCa patients.The present stu...
1 CitationsSource
#1J. Ferlay (IARC: International Agency for Research on Cancer)H-Index: 18
#2Murielle Colombet (IARC: International Agency for Research on Cancer)H-Index: 8
Last. Freddie Bray (IARC: International Agency for Research on Cancer)H-Index: 119
view all 8 authors...
: Estimates of the worldwide incidence and mortality from 36 cancers and for all cancers combined for the year 2018 are now available in the GLOBOCAN 2018 database, compiled and disseminated by the International Agency for Research on Cancer (IARC). This paper reviews the sources and methods used in compiling the cancer statistics in 185 countries. The validity of the national estimates depends upon the representativeness of the source information, and to take into account possible sources of bi...
2,344 CitationsSource
#1Maarten Cuypers (Radboud University Nijmegen)H-Index: 8
#2Romy E.D. LamersH-Index: 8
Last. Marieke de Vries (Radboud University Nijmegen)H-Index: 19
view all 5 authors...
Abstract Objective To investigate the effect of including an online decision aid (DA) during prostate cancer treatment counseling on decisional regret and information satisfaction in a one-year follow-up. Methods Within a cluster RCT, 18 Dutch hospitals were randomized to DA counseling or care-as-usual, patients (n = 382) initially completed questionnaires directly after treatment decision making. Six and twelve months later regret (Decisional Regret Scale) and information satisfaction (SCIP-B) ...
10 CitationsSource
#1Allan Ben Smith (UNSW: University of New South Wales)H-Index: 17
#2Orlando Rincones (UNSW: University of New South Wales)H-Index: 3
Last. Afaf Girgis (UNSW: University of New South Wales)H-Index: 67
view all 9 authors...
Abstract Objective To understand how best to support men diagnosed with localised prostate cancer to decide which treatment option best suits their needs, when robotic prostatectomy and radiotherapy are equally appropriate to offer them. Methods Twenty-five men recently diagnosed with localised prostate cancer completed semi-structured interviews asking about information/decision-making needs before and/or after attending a combined clinic in which they consulted a urologist and a radiation onco...
6 CitationsSource
#1Freddie Bray (IARC: International Agency for Research on Cancer)H-Index: 18
#1Freddie Bray (IARC: International Agency for Research on Cancer)H-Index: 119
Last. Ahmedin Jemal (ACS: American Cancer Society)H-Index: 139
view all 6 authors...
This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer...
31.7k CitationsSource
Cited By0