and community services. Once the organisational structure and funding for treating these relatively well defined conditions has been established it may be reasonable to consider the potentially larger issue of intravenous treatment for patients with acute infections in the community. We are concerned that the pace for change is being set by a few clinical enthusiasts and by commercial organisations who have a vested interest in promoting community intravenous care. The NHS deserves a more organised strategy for purchasing treatment with intravenous antibiotics in the community.

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and autonomy level, drug dispensation, radiotherapy sessions, use of health-care resources, day-hospital visits, hospitalization events, use of nursing homes, non-urgent sanitary transport, monthly and annual costs (V) per patient (and 3 year/survival) Variables were compared between the group medical treatment vs. the group surgical treatment using unpaired parametric tests. Since this is an observational study, no formal calculation of sample size was pretended. Yet, post-hoc results identified a cohort of 13.415 participants, which should be enough for descriptive purposes. Result: 3 year/Survival after LC diagnosis was much higher in surgical patients (78,9% vs 23,3%) (p<0.001). Surgically treated patients achieve a higher level of autonomy earlier before diagnosis. The monthly rate of total drug dispensation, cancer drugs, radiotherapy sessions, opioid and analgesic dispensation before and after LC diagnosis were much higher in medical patients. The rate of dispensation of ansiolitic, sedatives and anti-depressives were similar in both groups. Hospitalization events were slightly higher in the surgical group. There were no significant differences between groups in the rate of primary care or hospital outpatient clinic visits. The use of Health-care resources and non-emergency sanitary transport peaked before diagnosis to a larger extend in medical patients. The average annual cost of medical and surgical patients one year after LC diagnosis and treatment was 67% higher in medical patients (17.495 vs. 10.447 V). Conclusion: Surgical treatment of LC offers better clinical outcomes and is cost-efficient. These arguments support the implementation of large scale LC screening programs to increase the number of potential LC patients that can benefit from this treatment.