Department of Urology, The Johns Hopkins Hospital, Baltimore, Maryland 21231, USA.
Prostate. 2012 Jan;72(1):58-64. doi: 10.1002/pros.21406. Epub 2011 Apr 25.
The literature lacks knowledge about information preferences and decision-making in young prostate cancer patients. This study provides insight into information sources consulted and factors dictating treatment decision-making in young prostate cancer patients.
Subjects were identified from pathology consult service of a National Center of Excellence. Questionnaires were mailed to 986 men, under 50 years of age, diagnosed with Gleason score 6 prostate cancer between 2001 and 2005.
Four hundred ninety-three men responded. The most common primary therapies were surgery 397 (81.4%), radiation 52 (10.7%), and active surveillance (AS) 26 (5.3%). Participants with at least some college education (P = 0.003) or annual income >$100,000 (P = 0.003) were more likely to consult three or more doctors. Amongst all treatments, "doctor's recommendation" was the most influential information source, although relatively less important in the AS group. Internet was the second most frequent information source. Participants with higher education (P = 0.0003) and higher income (P = 0.002) considered sexual function more important while making a treatment choice. Only 2% of the men preferred a passive role in the decision-making. Informed decision-making was preferred more by patients who chose radiation and AS while shared decision-making was preferred more by surgery patients (P < 0.05). The majority (89%) of the respondents did not regret their decision. No difference in satisfaction levels was found between different treatment modalities.
This study provides insight into information sources consulted, such as the greater internet use, and various factors dictating treatment decision-making in young prostate cancer patients. There was an overall very high satisfaction rate regardless of the therapy chosen.
目前文献中缺乏有关年轻前列腺癌患者信息偏好和决策的知识。本研究旨在深入了解年轻前列腺癌患者咨询的信息来源和影响治疗决策的因素。
从国家卓越中心的病理咨询服务中确定研究对象。2001 年至 2005 年间，向 986 名年龄在 50 岁以下、诊断为 Gleason 评分 6 前列腺癌的男性邮寄问卷。
493 名男性做出回应。最常见的主要治疗方法是手术 397 例（81.4%）、放疗 52 例（10.7%）和主动监测（AS）26 例（5.3%）。至少受过大学教育（P = 0.003）或年收入超过 100,000 美元（P = 0.003）的参与者更有可能咨询三位或更多医生。在所有治疗方法中，“医生的建议”是最有影响力的信息来源，尽管在 AS 组中相对不太重要。互联网是第二大常用信息来源。受教育程度较高（P = 0.0003）和收入较高（P = 0.002）的参与者在做出治疗选择时更看重性功能。只有 2%的男性在决策中更喜欢被动角色。选择放疗和 AS 的患者更倾向于知情决策，而选择手术的患者更倾向于共同决策（P < 0.05）。大多数（89%）患者对自己的决定不后悔。不同治疗方式之间的满意度水平没有差异。
本研究深入了解了年轻前列腺癌患者咨询的信息来源，如更多地使用互联网，以及影响他们治疗决策的各种因素。无论选择哪种治疗方式，总体满意度都非常高。
