Longitudinal changes in factors affecting postoperative patient satisfaction after robot-assisted radical prostatectomy: an assessment using a patient-reported questionnaire

摘要

BACKGROUND: Long-term survival can be achieved in patients with localized prostate cancer (PCa). Therefore, maintenance of postoperative quality of life (QOL) and treatment satisfaction are important. Although longitudinal changes in disease-specific QOL are reported, there are few studies investigating which factors longitudinally affect treatment satisfaction in patients who undergo robot-assisted radical prostatectomy (RARP). Therefore, we examined the factors associated with treatment satisfaction over the first 12 months postoperatively based on an assessment using a patient-reported questionnaire. METHODS: Of the 612 consecutive patients who underwent RARP, 408 patients were enrolled in this study and divided into a satisfied group and a non-satisfied group at every evaluation timepoint. Multivariate logistic regression analysis was conducted to clarify factors affecting the postoperative treatment satisfaction between the two groups. RESULTS: Multivariate logistic regression analysis revealed that factors relating to treatment satisfaction had longitudinally changed. Urinary bother (UB) (odds ratio (OR) = 1.023; p = 0.008), and sexual function (SF) (OR = 0.941; p = 0.004) were the significant factors associated with treatment satisfaction at 1 month postoperatively; UB (OR = 1.040; p = 0.001) and sexual bother (SB) (OR = 1.019; p < 0.001) at 3 months; urinary function (UF) (OR = 1.027; p = 0.008), UB (OR = 1.035; p = 0.011), SB (OR = 1.013; p = 0.009), and hormonal bother (HB) (OR = 1.065; p = 0.023) at 6 months; UF (OR = 1.026; p = 0.008), UB (OR = 1.030; p = 0.029), and SB (OR = 1.014; p = 0.004) at 9 months; UF (OR = 1.024; p = 0.002) at 12 months. CONCLUSIONS: Treatment satisfaction in patients who underwent RARP changed over time. Our results suggest that giving sufficient information before treatment choice is both important and useful for patients' decision-making, leading to improved patient QOL.