Association of Patient Comorbidities With Treatment Regret Among Patients With Localized Prostate Cancer - Results From a Population-Based Cohort.

[PURPOSE] Decision regret is a well-established negative outcome in prostate cancer. We hypothesized that baseline comorbidities, which impact treatment tolerability, are associated with regret.

[METHODS AND MATERIALS] In a prospective, population-based cohort of patients with prostate cancer, patient-reported regret was assessed at 12 months after treatment using a validated measure. Comorbidities were assessed using medical record abstraction and scored using the validated National Cancer Institute Comorbidity Index. Multivariable logistic regression was used to assess the association between the comorbidity score and regret, accounting for treatment-related symptoms, treatment received, and sociodemographic measures.

[RESULTS] This was a diverse cohort, comprising 25.3% Black patients and 24.2% living in rural areas. A total of 108 out of 981 patients (11%) reported regret. In multivariable analysis, comorbidity score (odds ratio [OR], 1.58; p < .05), not being married (OR, 1.72; p = .04), worsening of bowel symptoms (OR, 2.12; p < .01), and worsening of urinary obstruction/irritation (OR, 1.60; p = .05) were associated with decision regret. In addition, radiation therapy was associated with less regret compared with radical prostatectomy (OR, 0.48; p = .015).

[CONCLUSIONS] Among men with localized prostate cancer, baseline comorbidity burden was associated with increased decision regret. These results illustrate the importance of assessing baseline comorbidities and incorporating their consideration into the treatment decision-making process, ensuring that patients have realistic expectations and make informed decisions.