Cancers (Oct 2022)
Patients Regret Their Choice of Therapy Significantly Less Frequently after Robot-Assisted Radical Prostatectomy as Opposed to Open Radical Prostatectomy: Patient-Reported Results of the Multicenter Cross-Sectional IMPROVE Study
- Ingmar Wolff,
- Martin Burchardt,
- Christian Gilfrich,
- Julia Peter,
- Martin Baunacke,
- Christian Thomas,
- Johannes Huber,
- Rolf Gillitzer,
- Danijel Sikic,
- Christian Fiebig,
- Julie Steinestel,
- Paola Schifano,
- Niklas Löbig,
- Christian Bolenz,
- Florian A. Distler,
- Clemens Huettenbrink,
- Maximilian Janssen,
- David Schilling,
- Bara Barakat,
- Nina N. Harke,
- Christian Fuhrmann,
- Andreas Manseck,
- Robert Wagenhoffer,
- Ekkehard Geist,
- Lisa Blair,
- Jesco Pfitzenmaier,
- Bettina Reinhardt,
- Bernd Hoschke,
- Maximilian Burger,
- Johannes Bründl,
- Marco J. Schnabel,
- Matthias May
Affiliations
- Ingmar Wolff
- Department of Urology, University Medicine Greifswald, 17475 Greifswald, Germany
- Martin Burchardt
- Department of Urology, University Medicine Greifswald, 17475 Greifswald, Germany
- Christian Gilfrich
- Department of Urology, St. Elisabeth Hospital Straubing, 94315 Straubing, Germany
- Julia Peter
- Department of Urology, St. Elisabeth Hospital Straubing, 94315 Straubing, Germany
- Martin Baunacke
- Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Christian Thomas
- Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Johannes Huber
- Department of Urology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
- Rolf Gillitzer
- Department of Urology, Klinikum Darmstadt, 64283 Darmstadt, Germany
- Danijel Sikic
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany
- Christian Fiebig
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, 91054 Erlangen, Germany
- Julie Steinestel
- Department of Urology, University Hospital Augsburg, 86156 Augsburg, Germany
- Paola Schifano
- Department of Urology, University Hospital Augsburg, 86156 Augsburg, Germany
- Niklas Löbig
- Department of Urology, University Hospital Ulm, 89081 Ulm, Germany
- Christian Bolenz
- Department of Urology, University Hospital Ulm, 89081 Ulm, Germany
- Florian A. Distler
- Department of Urology, Paracelsus Medical University, 90419 Nuremberg, Germany
- Clemens Huettenbrink
- Department of Urology, Paracelsus Medical University, 90419 Nuremberg, Germany
- Maximilian Janssen
- Department of Urology, Isarklinikum Hospital Munich, 80331 Munich, Germany
- David Schilling
- Department of Urology, Isarklinikum Hospital Munich, 80331 Munich, Germany
- Bara Barakat
- Department of Urology and Pediatric Urology, Hospital Viersen, 41747 Viersen, Germany
- Nina N. Harke
- Department of Urology and Urologic Oncology, Hanover Medical School, 30625 Hanover, Germany
- Christian Fuhrmann
- Department of Urology and Urologic Oncology, Hanover Medical School, 30625 Hanover, Germany
- Andreas Manseck
- Department of Urology, Klinikum Ingolstadt, 85049 Ingolstadt, Germany
- Robert Wagenhoffer
- Department of Urology, Klinikum Ingolstadt, 85049 Ingolstadt, Germany
- Ekkehard Geist
- Department of Urology, Klinikum Neumarkt, 92318 Neumarkt Oberpfalz, Germany
- Lisa Blair
- Department of Urology, Klinikum Neumarkt, 92318 Neumarkt Oberpfalz, Germany
- Jesco Pfitzenmaier
- Department of Urology, Evangelical Hospital Bethel, University Hospital Ostwestfalen-Lippe of the University Bielefeld, 33611 Bielefeld, Germany
- Bettina Reinhardt
- Department of Urology, Evangelical Hospital Bethel, University Hospital Ostwestfalen-Lippe of the University Bielefeld, 33611 Bielefeld, Germany
- Bernd Hoschke
- Department of Urology and Pediatric Urology, Carl-Thiem-Klinikum Cottbus, 03048 Cottbus, Germany
- Maximilian Burger
- Department of Urology, Caritas - St. Josef Medical Center, University of Regensburg, 93053 Regensburg, Germany
- Johannes Bründl
- Department of Urology, Caritas - St. Josef Medical Center, University of Regensburg, 93053 Regensburg, Germany
- Marco J. Schnabel
- Department of Urology, Caritas - St. Josef Medical Center, University of Regensburg, 93053 Regensburg, Germany
- Matthias May
- Department of Urology, St. Elisabeth Hospital Straubing, 94315 Straubing, Germany
- DOI
- https://doi.org/10.3390/cancers14215356
- Journal volume & issue
-
Vol. 14,
no. 21
p. 5356
Abstract
Patient’s regret (PatR) concerning the choice of therapy represents a crucial endpoint for treatment evaluation after radical prostatectomy (RP) for prostate cancer (PCA). This study aims to compare PatR following robot-assisted (RARP) and open surgical approach (ORP). A survey comprising perioperative-functional criteria was sent to 1000 patients in 20 German centers at a median of 15 months after RP. Surgery-related items were collected from participating centers. To calculate PatR differences between approaches, a multivariate regressive base model (MVBM) was established incorporating surgical approach and demographic, center-specific, and tumor-specific criteria not primarily affected by surgical approach. An extended model (MVEM) was further adjusted by variables potentially affected by surgical approach. PatR was based on five validated questions ranging 0–100 (cutoff >15 defined as critical PatR). The response rate was 75.0%. After exclusion of patients with laparoscopic RP or stage M1b/c, the study cohort comprised 277/365 ORP/RARP patients. ORP/RARP patients had a median PatR of 15/10 (p 15, respectively (p 15 relative 46.8% less frequently (p < 0.001). Consensual decision making regarding surgical approach independently reduced PatR. With the MVEM, the independent impact of both surgical approach and of consensual decision making was confirmed. This study involving centers of different care levels showed significantly lower PatR following RARP.
Keywords
- prostate cancer
- radical prostatectomy
- clinical decision-making
- decision regret
- characterization of patients
- survey