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

Wolff I, Burchardt M, Gilfrich C, Peter J, Baunacke M, Thomas C, Huber J, Gillitzer R, Sikic D, Fiebig C, Steinestel J, Schifano P, Loebig N, Bolenz C, Distler FA, Huettenbrink C, Janssen M, Schilling D, Barakat B, Harke NN, Fuhrmann C, Manseck A, Wagenhoffer R, Geist E, Blair L, Pfitzenmaier J, Reinhardt B, Hoschke B, Burger M, Bruendl J, Schnabel MJ, May M (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Cancers MDPI

Book Volume: 14

Article Number: 5356

Journal Issue: 21

DOI: 10.3390/cancers14215356

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 < 0.001) and 46.2%/28.1% had a PatR >15, respectively (p < 0.001). Based on the MVBM, RARP patients showed PatR >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.

Authors with CRIS profile

Christian Fiebig Urologische Klinik

Involved external institutions

Universitätsmedizin Greifswald / Universitätsklinikum Greifswald DE Germany (DE) Klinikum St. Elisabeth Straubing GmbH DE Germany (DE) Technische Universität Dresden DE Germany (DE) Klinikum Darmstadt DE Germany (DE) Universitätsklinikum Augsburg DE Germany (DE) Universitätsklinikum Ulm DE Germany (DE) Paracelsus Medizinische Privatuniversität AT Austria (AT) Isarklinikum (Isar Kliniken GmbH) DE Germany (DE) Medizinische Hochschule Hannover (MHH) / Hannover Medical School DE Germany (DE) Klinikum Ingolstadt DE Germany (DE) Kliniken des Landkreises Neumarkt i.d.OPf. DE Germany (DE) Universität Bielefeld DE Germany (DE) Carl-Thiem-Klinikum DE Germany (DE) Universität Regensburg DE Germany (DE)

How to cite

APA:

Wolff, I., Burchardt, M., Gilfrich, C., Peter, J., Baunacke, M., Thomas, C.,... May, M. (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. Cancers, 14(21). https://doi.org/10.3390/cancers14215356

MLA:

Wolff, Ingmar, et al. "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." Cancers 14.21 (2022).

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