Zhong Wenjie, Haghighi Kayvan, Rathore Prem, Wong Eddy, Mancuso Pascal
Department of Urology, Liverpool Hospital, Corner of Elizabeth and Goulburn Street, Liverpool, NSW, 2170, Australia.
J Robot Surg. 2018 Jun;12(2):215-221. doi: 10.1007/s11701-018-0796-3. Epub 2018 Mar 16.
Robot-assisted radical prostatectomy to treat localized prostate cancer has increased in popularity, although other options exist, including radiotherapy and active surveillance. The decision about choosing the right treatment has become pertinent for many patients. This literature review aimed to assess the current state-of-the-art regarding decisional aids and the associated decisional outcomes for the purpose of designing a method for both patients and doctors to use to make the best treatment decision for the patient. A literature search was conducted via MEDLINE, Embase, and Web of Science databases using the keywords "prostate" and "cancer" and "impact" and "decisio*" and "treatment." Articles were included that focused on treatment outcomes, decision-making processes, and the use of decisional aids for localized prostate cancer. Articles that investigated prostate cancer in general or prostate cancer screening were excluded, as were articles that were not written in English. Altogether, 13 articles were finally critically reviewed for this study. Results were conflicting regarding the relations between patient factors, use of decisional aids, and decisional outcomes. There was a large gap in the literature regarding the optimal decision-making process for men with localized prostate cancer. The role of currently available decisional aids is limited to helping patients make the right decisions. There is a need to develop a novel decisional aid in which patient-physician discussion-involving evaluation of a spectrum of patient-, doctor-, and treatment-related factors-is included.
机器人辅助根治性前列腺切除术用于治疗局限性前列腺癌的情况越来越普遍，尽管还有其他选择，包括放射治疗和主动监测。对于许多患者来说，选择正确治疗方法的决定变得至关重要。这篇文献综述旨在评估关于决策辅助工具的当前技术水平以及相关的决策结果，以便设计一种供患者和医生使用的方法，为患者做出最佳治疗决策。通过MEDLINE、Embase和科学网数据库进行文献检索，使用关键词“前列腺”、“癌症”、“影响”、“决策*”和“治疗”。纳入的文章聚焦于局限性前列腺癌的治疗结果、决策过程以及决策辅助工具的使用。排除那些总体研究前列腺癌或前列腺癌筛查的文章，以及非英文撰写的文章。本研究最终对13篇文章进行了严格审查。关于患者因素、决策辅助工具的使用和决策结果之间的关系，结果相互矛盾。关于局限性前列腺癌男性的最佳决策过程，文献中存在很大差距。目前可用的决策辅助工具的作用仅限于帮助患者做出正确决策。有必要开发一种新颖的决策辅助工具，其中包括患者与医生的讨论，涉及对一系列患者、医生和治疗相关因素的评估。
