Objective:Robot-assisted radical prostatectomy(RARP)is the most commonly performed surgical treatment for prostate cancer.However,decision regret(DR)represents a concern for both patients undergoing the procedure and ...Objective:Robot-assisted radical prostatectomy(RARP)is the most commonly performed surgical treatment for prostate cancer.However,decision regret(DR)represents a concern for both patients undergoing the procedure and clinicians involved in therapeutic management.To address this need,we performed a systematic review exploring DR severity and its associations after RARP.Methods:A comprehensive search in scientific literature databases(PubMed,Embase,Scopus,and Web of Science)identified studies on DR in RARP-treated patients.All studies objectively evaluating DR were included.Within studies using the validated 5-item DR scale(range 0-100),the pooled estimate was calculated using fixedand random-effects models accounting for different follow-ups.A qualitative synthesis analyzed the impact of multiple baseline,perioperative,and postoperative factors on DR.Results:We retrieved 493 articles using our search strategy,with 15 meeting inclusion criteria.A total of 3480 prostate cancer patients with objective DR assessment after RARP were identified.The median follow-up ranged from 4.8 months to 6.3 years while response rates varied between 45% and 100%.Among the included studies,10 used the Decision Regret Scale,with a pooled mean estimate of 15.22(95%confidence interval 11.52-18.93)under the random-effects model.In the remaining five studies,DR was generally low(65%-75%)and even absent in some(12%-49%).Functional outcomes,such as continence and potency,were the most frequently reported factors significantly associated with DR.However,variability in assessing DR and other outcomes limits the ability to draw definitive conclusions.Conclusion:Most patients report low DR after RARP.Functional outcomes correlate with DR,but the heterogeneity in assessments and reporting methods warrants the need for more standardized evaluation.展开更多
文摘Objective:Robot-assisted radical prostatectomy(RARP)is the most commonly performed surgical treatment for prostate cancer.However,decision regret(DR)represents a concern for both patients undergoing the procedure and clinicians involved in therapeutic management.To address this need,we performed a systematic review exploring DR severity and its associations after RARP.Methods:A comprehensive search in scientific literature databases(PubMed,Embase,Scopus,and Web of Science)identified studies on DR in RARP-treated patients.All studies objectively evaluating DR were included.Within studies using the validated 5-item DR scale(range 0-100),the pooled estimate was calculated using fixedand random-effects models accounting for different follow-ups.A qualitative synthesis analyzed the impact of multiple baseline,perioperative,and postoperative factors on DR.Results:We retrieved 493 articles using our search strategy,with 15 meeting inclusion criteria.A total of 3480 prostate cancer patients with objective DR assessment after RARP were identified.The median follow-up ranged from 4.8 months to 6.3 years while response rates varied between 45% and 100%.Among the included studies,10 used the Decision Regret Scale,with a pooled mean estimate of 15.22(95%confidence interval 11.52-18.93)under the random-effects model.In the remaining five studies,DR was generally low(65%-75%)and even absent in some(12%-49%).Functional outcomes,such as continence and potency,were the most frequently reported factors significantly associated with DR.However,variability in assessing DR and other outcomes limits the ability to draw definitive conclusions.Conclusion:Most patients report low DR after RARP.Functional outcomes correlate with DR,but the heterogeneity in assessments and reporting methods warrants the need for more standardized evaluation.
