Anxiety about recurrence or metastasis after nephrectomy and perspectives on and preferences for adjuvant therapy among patients with renal cell carcinoma in Japan: a cross-sectional web-based survey

Nobuyuki Hinata, Kumiko Miyajima, Shotaro Yasuoka, Takuto Tokudome, Shingo Kojima, Sona-Sanae Aoyagi, Wen Zhang, Yuichiro Ito

Purpose Understanding concerns about recurrence or metastasis after nephrectomy and preferences for adjuvant therapy among patients with renal cell carcinoma (RCC) is important for facilitating shared decision-making between patients and physicians. We conducted a web-based survey to assess anxiety about recurrence or metastasis after nephrectomy and to describe treatment perspectives and preferences regarding adjuvant therapy among patients with RCC in Japan. Methods In this non-interventional, cross-sectional descriptive study, patient-reported data were collected using a web-based questionnaire. Eligible patients with RCC who had undergone radical or partial nephrectomy were recruited through the Rakuten Panel. Anxiety about recurrence or metastasis was assessed using a visual analog scale. The survey was conducted between 27 October and 7 November 2023. Results A total of 447 eligible patients participated in the survey, of whom 410 (91.7%) were men. The most frequent age group was patients in their 60s (42.5%), followed by those in their 70s (29.1%) and 50s (19.0%). The mean anxiety score regarding recurrence or metastasis after nephrectomy was 3.8 (SD 2.8) on a visual analog scale (VAS; 0–9). Among the 387 patients (86.6%) who reported anxiety about recurrence or metastasis immediately after surgery, 243 (62.8%) reported that information provided by medical professionals, including physicians and nurses, was the most effective in reducing anxiety. More than half of the participating patients (61.7%) preferred to receive adjuvant therapy that has been shown to reduce or delay the risk of recurrence or metastasis, even in the absence of evidence for prolonging life. Conclusions This study describes patient-reported anxiety about recurrence or metastasis after nephrectomy and reported perspectives on adjuvant therapy among Japanese patients with RCC. The findings suggest that information provided by medical professionals may be perceived as helpful in reducing anxiety about recurrence or metastasis. In a hypothetical scenario, a substantial proportion of respondents indicated that they would prefer adjuvant therapy when it was presented as reducing or delaying recurrence or metastasis, even without an overall survival benefit. These findings should be interpreted with caution but may help inform shared decision-making and patient-centered postoperative care in RCC.