1.Decisional Trade-offs in Localized Prostate Cancer: A Prospective Cross-Sectional Study of Radical Prostatectomy, Radiation Therapy, and Active Surveillance
Hyunho HAN ; Youngdeuk CHOI ; Woong Kyu HAN ; Jihee JUNG ; Ayoung YOO ; Hyunji YOON ; Siyeong LEE ; Changhwa HYUN ; Woong Sub KOOM ; Ik Jae LEE ; Chan Woo WEE ; Jeongmi LEE ; Jae Young JEONG ; Hyung Ho LEE ; Young Ae KIM ; Jung Eun KIM ; Songhee EUN ; Sung Uk LEE ; Jinha JEONG ; Moonsoo RA
Journal of Urologic Oncology 2025;23(2):112-118
Purpose:
To evaluate patient‐reported experiences of 3 primary treatments for localized or locally advanced prostate cancer—radical prostatectomy (RP), radiation therapy (RT), and active surveillance (AS)—based on cross‐sectional data from a prospective registry, and to explore how these findings can inform a structured shared decision making (SDM) framework.
Materials and Methods:
Men with clinical stage cT3aN0M0 or lower were enrolled. Those who underwent RP or RT were surveyed 6–24 months posttreatment; men on AS had 6–60 months of follow‐up. All participants completed the EORTC QLQ‐PR25 (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Prostate Cancer Module), capturing urinary, bowel, hormonal, and sexual function. The Kruskal‐Wallis test evaluated group differences, with significance set at p<0.05.
Results:
Among 542 patients, 435 underwent RP, 73 received RT (43% with androgen deprivation therapy), and 34 were on AS. RP patients reported higher rates of urinary incontinence and sexual dysfunction, whereas RT patients had more severe urinary irritative and bowel symptoms. AS generally preserved baseline sexual function but still involved some urinary complaints and anxiety regarding disease progression. These findings underscore the distinct trade‐offs among the 3 management strategies, emphasizing the importance of individualized SDM that accounts for functional priorities and patient values.
Conclusion
Each treatment modality poses unique impacts on quality of life. Incorporating these patient‐reported data into SDM discussions can improve alignment between clinical recommendations and patient preferences, potentially reducing decisional regret and enhancing long‐term outcomes.
2.Risk of Cerebro-Cardiovascular Diseases among Police Officers and Firefighters:A Nationwide Retrospective Cohort Study
Jongin LEE ; Woo-Ri LEE ; Ki-Bong YOO ; Jaelim CHO ; Jinha YOON
Yonsei Medical Journal 2022;63(6):585-590
Purpose:
Police officers and firefighters are exposed to risk factors for cerebro-cardiovascular diseases, and the actual risk is expected to increase compared with other occupational groups. The present study aimed to estimate the risks of cerebro-cardiovascular diseases in police officers and firefighters compared to other occupational groups.
Materials and Methods:
Using the National Health Insurance Service data, we constructed a retrospective cohort of public officers. Three-year consecutive health insurance registration data were used to identify police officers and firefighters. Cerebro-cardiovascular diseases consisted of acute myocardial infarction, other ischemic heart disease, cardiac arrhythmia, and stroke. We compared the incidences of cerebro-cardiovascular diseases between each of the two occupational groups (police officers and firefighters) and other public officers by calculating standardized incidence ratios (SIRs).
Results:
SIRs and 95% confidence intervals of all cerebro-cardiovascular diseases for police officers and firefighters were 1.71 (1.66–1.76) and 1.22 (1.12–1.31), respectively, as compared with all public officers. The incidence ratios remained significantly higher compared to general and education officers. Subgroup analyses for myocardial infarction, stroke, and cardiac arrhythmia exhibited significant increases in incidence ratios among police officers and firefighters.
Conclusion
This study suggests that both police officers and firefighters are at high risk of cerebro-cardiovascular diseases.Therefore, medical protection measures for these occupational groups should be improved.

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