MP73-10: Patient-Reported Treatment Related Regret (TRR) Following Primary Partial Gland Cryoablation (PPGCA):A Prospective Cohort Study of Men with Localized Prostate Cancer
Introduction: TRR captures the effect of treatment-related functional impairments, oncologic anxiety and outcomes, and behavioral, emotional, and interpersonal changes associated with diagnosis and treatment within the context of patient values and expectations. The objective is to determine the rate of TRR following PPGCA and characterize factors predisposing to TRR. Methods: Men with prostate cancer undergoing PPGCA since 3/2017 were enrolled in a prospective outcome registry. Preoperative baseline characteristics (i.e., patient age, race, IPSS and SHIM, and Gleason Grade Group); post-operative outcomes (i.e., recurrence on surveillance biopsy, receipt of salvage treatment); and functional status (measured using the IPSS and SHIM) were recorded. Between June and August 2022, the Clark et al. validated prostate cancer-related treatment regret decision scale was distributed. A score =40 on the regret scale was considered significant TRR. Men were considered potent at baseline or post-treatment if their response to Question #2 of the SHIM was >2. Associations between significant treatment regret and baseline characteristics (i.e., patient age, race, IPSS, SHIM and preoperative GGG) and longitudinal outcomes (i.e., recurrence on surveillance biopsy, receipt of salvage treatment, a clinically significant change in IPSS, decline in potency or erectile function, and loss of potency among those who were potent at baseline) were assessed using logistic regressions. Results: 245 men met criteria for inclusion in the study, of whom 163 completed the survey (response rate: 66.5%). Significant TRR was expressed by 15.8% of men. Age, race, baseline erectile function, and Gleason Grade Group were not statistically significant predictors of TRR. Among those who were potent at baseline, loss of potency was associated with higher probability of significant TRR. Similarly, among those who had erectile function and severe LUTS at baseline, and loss of erectile function were associated with higher probabilities of significant TRR. No associations were identified between TRR and recurrence of csPCa or salvage treatment. Conclusions: The overwhelming majority of men do not express TRR following PPGCA. Baseline severe LUTS at baseline and the development of erectile dysfunction are factors predisposing to TRR. It is imperative to elucidate short, intermediate and long term functional and oncological outcomes predisposing to TRR in order to optimize outcomes. SOURCE OF Funding: None
