Hur Sonia S, Tzeng Michael, Cricco-Lizza Eliza, Basourakos Spyridon P, Yu Miko, Ancker Jessica, Abramson Erika, Saigal Christopher, Ross Ashley, Hu Jim
Department of Urology, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA.
Department of Healthcare Policy and Research, New York Presbyterian Hospital, Weill Cornell Medicine, New York, NY, USA.
BMJ Surg Interv Health Technol. 2021 Jun;3(1). doi: 10.1136/bmjsit-2020-000068.
OBJECTIVES –: Partial gland ablation (PGA) therapy is an emerging treatment modality that targets specific areas of biopsy proven prostate cancer (PCa) to minimize treatment-related morbidity by sparing benign prostate. This qualitative study aims to explore and characterize perceptions and attitudes toward PGA in men with very-low-risk, low-risk, and favorable intermediate-risk PCa on active surveillance (AS).
DESIGN –: 92 men diagnosed with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS were invited to participate in semi-structured telephone interviews on PGA.
SETTING –: Single tertiary care center located in New York City.
PARTICIPANTS –: 20 men with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS participated in the interviews.
MAIN OUTCOME MEASURES –: Emerging themes on perceptions and attitudes toward PGA were developed from transcripts inductively coded and analyzed under standardized methodology.
RESULTS –: Four themes were derived from twenty interviews that represent the primary considerations in treatment decision-making: (1) the feeling of psychological safety associated with low-risk disease; (2) preference for minimally invasive treatments; (3) the central role of the physician; (4) and the pursuit of treatment options that align with disease severity. Eleven men (55%) expressed interest in pursuing PGA only if their cancer were to progress, while 9 men (45%) expressed interest at the current moment.
CONCLUSIONS –: Though an emerging treatment modality, patients were broadly accepting of PGA for PCa with men primarily debating the risks versus benefits of proactively treating low-risk disease. Additional research on men's preferences and attitudes toward PGA will further guide counseling and shared decision-making for PGA.
部分腺体消融（PGA）疗法是一种新兴的治疗方式，它针对经活检证实的前列腺癌（PCa）的特定区域，通过保留良性前列腺组织来尽量减少与治疗相关的发病率。这项定性研究旨在探讨和描述积极监测（AS）下极低风险、低风险和有利中风险PCa男性对PGA的认知和态度。
邀请92名经AS诊断为极低风险、低风险和有利中风险PCa的男性参加关于PGA的半结构化电话访谈。
位于纽约市的单一三级医疗中心。
20名经AS诊断为极低风险、低风险和有利中风险PCa的男性参加了访谈。
根据在标准化方法下进行归纳编码和分析的访谈记录，形成关于对PGA的认知和态度的新主题。
从20次访谈中得出了四个主题，这些主题代表了治疗决策中的主要考虑因素：（1）与低风险疾病相关的心理安全感；（2）对微创治疗的偏好；（3）医生的核心作用；（4）以及追求与疾病严重程度相匹配的治疗方案。11名男性（55%）表示只有在癌症进展时才对接受PGA感兴趣，而9名男性（45%）目前就表示感兴趣。
尽管PGA是一种新兴的治疗方式，但患者普遍接受将其用于PCa治疗，男性主要在积极治疗低风险疾病的风险与益处之间进行权衡。关于男性对PGA的偏好和态度的进一步研究将为PGA的咨询和共同决策提供进一步指导。
