Patient-reported Outcome Measures and Decision Regret After Prostate-specific Membrane Antigen–targeted Radioguided Surgery for Oligorecurrent Prostate Cancer
Bibliographic record
Abstract
In patients with oligorecurrent prostate cancer after radical prostatectomy, prostate-specific membrane antigen–targeted radioguided surgery (PSMA-RGS) may prolong treatment-free survival without negatively affecting the quality of life or any functional status domains, except sexual. More than 90% of the patients reported that PSMA-RGS was the correct decision after 1 yr. In patients with oligorecurrent prostate cancer (PCa), prostate-specific membrane antigen–targeted radioguided surgery (PSMA-RGS) prolongs treatment-free survival. Data on patient-reported outcome measures (PROMs) are lacking. A retrospective assessment of validated PROMs (12-item Short Form Health Survey [SF-12], 26-item Expanded Prostate Index Composite, and Decision Regret Scale [DRS]) was performed before and after PSMA-RGS for oligorecurrent PCa. Mixed models were used. A total of 373 patients were analyzed at a median (interquartile range [IQR]) age of 66 (61, 70) yr and prostate-specific antigen of 0.8 (0.4, 1.5) ng/ml. Six months after PSMA-RGS, the median (IQR) scores for the PROMs were as follows: SF-12 physical 54 (49, 56), SF-12 mental 53 (43, 56), urinary incontinence 86 (52, 100), urinary irritation 94 (88, 100), sexual 27 (9, 57), hormonal 90 (79, 100), and bowel 96 (83, 100). Only the sexual score decreased in a significant fashion from baseline over time (median [IQR], 17 [8,38]) after 3 yr vs 37 [13, 63] at baseline, p = 0.01). The decision regret remained low (median [IQR] DRS at 1 yr: 5 [0, 20]). More than 90% of the patients reported that PSMA-RGS was the correct decision after 1 yr. We recorded no significant decrease in quality of life or any functional status domain, except sexual. While decision regret was low, sexual functioning might deteriorate further. No significant deterioration in health-related quality of life was reported after removing early prostate cancer metastases. Very few patients expressed remorse about their decision for salvage surgery.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.016 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".