MP23-19 DECISION REGRET, ADVERSE OUTCOMES AND TREATMENT CHOICE IN MEN WITH LOCALIZED PROSTATE CANCER: RESULTS FROM A MULTI-SITE RANDOMIZED TRIAL

Abstract

You have accessJournal of UrologyProstate Cancer: Localized: Active Surveillance I (MP23)1 Apr 2020MP23-19 DECISION REGRET, ADVERSE OUTCOMES AND TREATMENT CHOICE IN MEN WITH LOCALIZED PROSTATE CANCER: RESULTS FROM A MULTI-SITE RANDOMIZED TRIAL Donna L. Berry*, Fangxin Hong, Traci Blonquist, Barbara Halpenny, Niya Xiong, Christopher P Filson, Viraj A Master, Martin G Sanda, Peter Chang, Gary Chien, Randy Jones, Tracey Krupski, Seth Wolpin, Leslie Wilson, Julia Hayes, Quoc-Dien Trinh, and Mitch Sokoloff Donna L. Berry*Donna L. Berry* More articles by this author , Fangxin HongFangxin Hong More articles by this author , Traci BlonquistTraci Blonquist More articles by this author , Barbara HalpennyBarbara Halpenny More articles by this author , Niya XiongNiya Xiong More articles by this author , Christopher P FilsonChristopher P Filson More articles by this author , Viraj A MasterViraj A Master More articles by this author , Martin G SandaMartin G Sanda More articles by this author , Peter ChangPeter Chang More articles by this author , Gary ChienGary Chien More articles by this author , Randy JonesRandy Jones More articles by this author , Tracey KrupskiTracey Krupski More articles by this author , Seth WolpinSeth Wolpin More articles by this author , Leslie WilsonLeslie Wilson More articles by this author , Julia HayesJulia Hayes More articles by this author , Quoc-Dien TrinhQuoc-Dien Trinh More articles by this author , and Mitch SokoloffMitch Sokoloff More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000856.019AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men diagnosed with localized prostate cancer must navigate a highly preference-sensitive decision between treatment options with varying adverse outcome profiles. Decisional regret has been documented in men after treatment. We evaluated whether use of a decision support tool previously shown to decrease decisional conflict also impacted post-treatment decisional regret. METHODS: Participants at 10 urology or radiation oncology clinics across the United States were randomized to receive personalized decision support via the Personal Patient Profile-Prostate or usual care. Symptoms were measured at baseline and 6 months after enrollment; decision regret was measured at 6 months along with medical records review to ascertain treatment choices. Regression modeling explored associations between regret, 6-month symptoms and baseline variables including race, study group, choice, D`Amico risk, and symptoms. RESULTS: At 6 months, 287 of 392 (73%) men returned questionnaires of which 257 (89%) had made a treatment choice. Of that group, 201/257 (78%) completely answered the regret scale. While there was no significant difference between study groups (p=0.360), univariate analyses revealed Black men (p=0.019), men with any hormonal symptoms (p=0.009), and men with any bowel symptoms (p=0.032) reported higher regret. Significant interactions between treatment choice, regret and symptoms were detected. Men receiving definitive treatment and reporting no hormonal symptoms reported lower regret compared to all others (p=0.002). Men choosing active surveillance and reporting bowel symptoms had higher regret compared to all others (p=0.002). Significant interactions were detected between race and study group (intervention vs usual care) in the multivariable model; use of Personal Patient Profile-Prostate was associated with significantly decreased decisional regret among Black men (p=0.037). CONCLUSIONS: Decisional regret was associated with active surveillance and adverse symptom outcomes for men of various races. The Personal Patient Profile-Prostate decision support tool may be most beneficial in minimizing decisional regret for Black men considering treatment options for newly-diagnosed prostate cancer. Source of Funding: NIH R01NR009692 © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e345-e346 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Donna L. Berry* More articles by this author Fangxin Hong More articles by this author Traci Blonquist More articles by this author Barbara Halpenny More articles by this author Niya Xiong More articles by this author Christopher P Filson More articles by this author Viraj A Master More articles by this author Martin G Sanda More articles by this author Peter Chang More articles by this author Gary Chien More articles by this author Randy Jones More articles by this author Tracey Krupski More articles by this author Seth Wolpin More articles by this author Leslie Wilson More articles by this author Julia Hayes More articles by this author Quoc-Dien Trinh More articles by this author Mitch Sokoloff More articles by this author Expand All Advertisement PDF downloadLoading ...