在治疗潜在可切除的胰腺腺癌时，治疗临床医师的治疗决策需要根据他们的识别力来做出，但当面临可以证明错误的决策时，他们可能会感到后悔，希望避免此种情况。一种基于后悔的决策模型被应用于评估神经支持治疗和手术疗法对于潜在可切除的胰腺腺癌的态度。将三种描述分为高、中、低死亡风险的临床情景呈现给60位被试（20位肿瘤科医生、20位胃肠病专家和20位外科医生），并要求他们根据0（无后悔）到100（最大后悔）的范围报告有关神经支持化疗的遗憾。采用门限模型和多层混合回归来分析被试对神经支持治疗的态度。低风险情景下，遗漏的后悔最小，高风险情景下遗憾最大（P <.001）。 由于限制而引起的遗漏的遗憾与引起遗憾的措施相反（P≤.001）。在高风险、中风险和低风险情景下，优先使用手术治疗而不是神经支持治疗的特定死亡率逐渐减少（P≤.001）。在手术中心工作量较低或非外科医生中，接受高特定死亡率的外科医生（P =.018）和工作人员（P =.010）会降低采用神经支持治疗的可能性。后悔驱动胰腺腺癌管理中的决策。成为外科医生或在手术中心工作量较低的专业人员会降低推荐神经支持治疗的可能性。版权所有©2023 Elsevier Inc.。保留所有权利。

When treating potentially resectable pancreatic adenocarcinoma, therapeutic decisions are left to the sensibility of treating clinicians who, faced with a decision that post hoc can be proven wrong, may feel a sense of regret that they want to avoid. A regret-based decision model was applied to evaluate attitudes toward neoadjuvant therapy versus upfront surgery for potentially resectable pancreatic adenocarcinoma.Three clinical scenarios describing high-, intermediate-, and low-risk disease-specific mortality after upfront surgery were presented to 60 respondents (20 oncologists, 20 gastroenterologists, and 20 surgeons). Respondents were asked to report their regret of omission and commission regarding neoadjuvant chemotherapy on a scale between 0 (no regret) and 100 (maximum regret). The threshold model and a multilevel mixed regression were applied to analyze respondents' attitudes toward neoadjuvant therapy.The lowest regret of omission was elicited in the low-risk scenario, and the highest regret in the high-risk scenario (P < .001). The regret of the commission was diametrically opposite to the regret of omission (P ≤ .001). The disease-specific threshold mortality at which upfront surgery is favored over the neoadjuvant therapy progressively decreased from the low-risk to the high-risk scenarios (P ≤ .001). The nonsurgeons working in or with lower surgical volume centers (P = .010) and surgeons (P = .018) accepted higher disease-specific mortality after upfront surgery, which resulted in the lower likelihood of adopting neoadjuvant therapy.Regret drives decision making in the management of pancreatic adenocarcinoma. Being a surgeon or a specialist working in surgical centers with lower patient volumes reduces the likelihood of recommending neoadjuvant therapy.Copyright © 2023 Elsevier Inc. All rights reserved.