Treatment of benign renal masses may often be unnecessary yet can lead to significant costs, morbidity and mortality. In this population, individual burdens such as decisional regret and financial costs associated with treatment are not well understood.
Members of a support group who have been diagnosed with benign renal tumors and reside in the United States were surveyed. In addition to demographic and clinical information, the survey evaluated decisional regret, using the modified decisional regret scale, and financial toxicity, using the Comprehensive Score for financial Toxicity (COST). Predictors of decisional regret (DRS score > 25) and financial toxicity were identified using univariate and multivariate logistic and linear regression analyses, respectively.
A total of 70 subjects provided complete demographic, clinical, and questionnaire data. Surgical or biopsy pathology was consistent with oncocytoma (47%), angiomyolipoma (43%), benign cysts (6%), oncocytic tumors (3%), and endometriosis (1%). Forty-nine (70%) patients received active treatment, while 21 patients (30%) elected surveillance. The distribution of decisional regret and financial toxicity scores are provided in Figure 1. Decisional regret was expressed by 34/70 (49%) of patients and was associated with increasing age (p = 0.04), smaller tumor size (p = 0.036), and use of surveillance versus active treatment (OR 1.6, p = 0.039) in univariate analysis. In multivariate analysis, only older age (p = 0.037) was significantly associated with decisional regret. Younger age (p < 0.001) and diagnosis of angiomyolipoma (p = 0.04) were associated with greater financial toxicity in univariate linear regression; however, income bracket (p = 0.051), treatment selection, and treatment associated complication were not.
High levels of treatment-associated decisional regret and financial toxicity were found among individuals with benign renal lesions, many of whom expected a malignant diagnosis and did not undergo additional diagnostic modalities. Improved counseling and diagnostic tools may limit the psychological and financial burdens in select populations with these benign entities.
Decisional Regret and Financial Toxicity among Patients with Benign Renal Masses
Category
Kidney Cancer > Other
Description
Presented By: Neil Mendhiratta
Authors: Neil Mendhiratta
Vidit Sharma
Jessica Wu
Debra Gottsleben
Dena Battle
Tyler Valdez
Christopher Saigal
Brian Shuch