Early patient-reported outcomes and decisional regret after robot-assisted radical prostatectomy: A prospective single-center cohort study.

This study aimed to evaluate the association between early postoperative patient-reported outcomes and decisional regret at 6 months following robot-assisted radical prostatectomy. A prospective, single-center observational study was conducted of 105 patients who underwent robot-assisted radical prostatectomy at a single-center hospital in Korea between May 2023 and December 2024. Quality of life and surgical satisfaction were assessed at 1 month and 6 months postoperatively using EORTC QLQ-PR25 and SSQ-8. Decisional regret was measured at 6 months using the Decisional Regret Scale, with a cutoff score of 25 defining higher regret. Three sequential logistic models were constructed. Model 1 included only baseline and perioperative clinical and pathological variables. Model 2 incorporated 1- month patient-reported outcomes and was considered an exploratory early prediction model. Model 3 additionally included 6-month patient-reported outcomes and was interpreted as an exploratory concurrent explanatory model. Receiver operating characteristic curve analysis was used to evaluate model discrimination. A total of 105 patients were analyzed. Model 1 demonstrated limited ability to predict decisional regret at 6 months (area under the curve (AUC = 0.631). Incorporating 1-month patient-reported outcomes improved discriminative performance (model 2, AUC = 0.728), while including 6-month patient-reported outcomes further improved discrimination (model 3, AUC = 0.849). Patient-reported satisfaction at 1 month was independently associated with decisional regret at 6 months in model 2. Model 3 showed a strong concurrent association between 6-month satisfaction and decisional regret. Early postoperative patient-reported satisfaction may serve as a preliminary indicator for decisional regret following robot-assisted radical prostatectomy. Incorporating early satisfaction assessment into routine care could help identify patients at high risk of regret and support timely patient-centered counseling for patients at risk of postoperative decisional regret.