Journal article
Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study
Journal of clinical oncology, Vol.35(20), pp.2306-2314
07/10/2017
DOI: 10.1200/JCO.2016.70.6317
PMCID: PMC5501361
PMID: 28493812
Abstract
Purpose To determine the demographic, clinical, decision-making, and quality-of-life factors that are associated with treatment decision regret among long-term survivors of localized prostate cancer. Patients and Methods We evaluated men who were age ≤ 75 years when diagnosed with localized prostate cancer between October 1994 and October 1995 in one of six SEER tumor registries and who completed a 15-year follow-up survey. The survey obtained demographic, socioeconomic, and clinical data and measured treatment decision regret, informed decision making, general- and disease-specific quality of life, health worry, prostate-specific antigen (PSA) concern, and outlook on life. We used multivariable logistic regression analyses to identify factors associated with regret. Results We surveyed 934 participants, 69.3% of known survivors. Among the cohort, 59.1% had low-risk tumor characteristics (PSA < 10 ng/mL and Gleason score < 7), and 89.2% underwent active treatment. Overall, 14.6% expressed treatment decision regret: 8.2% of those whose disease was managed conservatively, 15.0% of those who received surgery, and 16.6% of those who underwent radiotherapy. Factors associated with regret on multivariable analysis included reporting moderate or big sexual function bother (reported by 39.0%; OR, 2.77; 95% CI, 1.51 to 5.0), moderate or big bowel function bother (reported by 7.7%; OR, 2.32; 95% CI, 1.04 to 5.15), and PSA concern (mean score 52.8; OR, 1.01 per point change; 95% CI, 1.00 to 1.02). Increasing age at diagnosis and report of having made an informed treatment decision were inversely associated with regret. Conclusion Regret was a relatively infrequently reported outcome among long-term survivors of localized prostate cancer; however, our results suggest that better informing men about treatment options, in particular, conservative treatment, might help mitigate long-term regret. These findings are timely for men with low-risk cancers who are being encouraged to consider active surveillance.
Details
- Title: Subtitle
- Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study
- Creators
- Richard M Hoffman - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJMary Lo - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJJack A Clark - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJPeter C Albertsen - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJMichael J Barry - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJMichael Goodman - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJDavid F Penson - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJJanet L Stanford - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJAntoinette M Stroup - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJAnn S Hamilton - Richard M. Hoffman, University of Iowa Carver College of Medicine; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA; Mary Lo and Ann S. Hamilton, Keck School of Medicine of the University of Southern California, Los Angeles, CA; Jack A. Clark, Edith Nourse Rogers Veterans Affairs Memorial Hospital, Bedford; Boston University School of Public Health; Michael J. Barry, Massachusetts General Hospital; Harvard Medical School, Boston, MA; Peter C. Albertsen, University of Connecticut Health Center, Farmington, CT; Michael Goodman, Emory University, Atlanta, GA; David F. Penson, Vanderbilt University, Nashville, TN; Janet L. Stanford, Fred Hutchinson Cancer Research Center, Seattle, WA; and Antoinette M. Stroup, Rutgers School of Public Health, Piscataway; Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
- Resource Type
- Journal article
- Publication Details
- Journal of clinical oncology, Vol.35(20), pp.2306-2314
- DOI
- 10.1200/JCO.2016.70.6317
- PMID
- 28493812
- PMCID
- PMC5501361
- NLM abbreviation
- J Clin Oncol
- ISSN
- 0732-183X
- eISSN
- 1527-7755
- Grant note
- N01 PC067010 / NCI NIH HHS N01 PC067006 / NCI NIH HHS N01 PC067009 / NCI NIH HHS P30 CA086862 / NCI NIH HHS R01 CA114524 / NCI NIH HHS
- Language
- English
- Date published
- 07/10/2017
- Academic Unit
- Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984094555102771
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