Active surveillance vs. treatment for low-risk prostate cancer: A cost comparison

Eldefrawy, Ahmed; Katkoori, Devendar; Abramowitz, Matthew C.; Soloway, Mark S.; Manoharan, Murugesan

doi:10.1016/j.urolonc.2011.04.005

Cited by 56 publications

(71 citation statements)

References 25 publications

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“…The reviewed articles represent health care delivery systems in France 35,37 , Germany 35 , Italy 35 , Spain 35 , the United Kingdom 35 , and the United States [24][25][26][27][28][29][30][31][32][33][34]36,38,39 . The studies assessed health care resource use and associated costs for 1990-2010.…”

Section: Study Characteristicsmentioning

confidence: 99%

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Direct Cost for Initial Management of Prostate Cancer: A Systematic Review

et al. 2013

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Background: Prostate cancer (pca) is the most common non-skin cancer among men in Canada and other Western countries. Increased prevalence and higher cost of newer treatments have led to a significant rise in the economic burden of pca. The objectives of the present study were to systematically review the literature on direct costs for the initial management of pca, and to examine the methodologic considerations across studies. Methods: Bibliographic databases were systematically searched for peer-reviewed articles in English. Studies were reviewed for methodologic considerations and mean direct cost of active surveillance or watchful waiting (as/ww) and initial treatments. Direct cost was standardized to 2011 Canadian dollars. Results: After a review of abstracts and full-text papers, seventeen articles met the eligibility criteria and were included in the review. Studies were published during 1992–2010. The studies reported on health care systems in the United States, France, the United Kingdom, German, Italy, and Spain. Our review identified a lack of methodologic consensus, leading to variation in direct costs between studies. Nevertheless, results indicate a significant direct cost of pca treatments. Conclusions: The existing literature lacks methodologically rigorous studies on the direct costs of pca treatments specific to publicly funded health care systems. Additional studies are required to appreciate the direct costs of newer treatments and the impact of their adoption on the growing economic burden of pca management.

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Section: Study Characteristicsmentioning

confidence: 99%

“…The studies assessed health care resource use and associated costs for 1990-2010. Study subjects were drawn from national 26,[28][29][30][33][34][35][37][38][39] or single-centre 24,25,27,31,32,36 populations, and sample sizes ranged between 33 and 120,000 patients 25,30 .…”

Section: Study Characteristicsmentioning

confidence: 99%

Direct Cost for Initial Management of Prostate Cancer: A Systematic Review

et al. 2013

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“…The total actual costs associated with RARP were significantly greater than those for ORP [40,41]. According to the statistics [42], the 1-, 2-, 5-, and 10-year cumulative cost of RARP was $17,824, $18,308, $20,117, and $22,762, respectively, vs. $9,732, $10,360, $12,209, and $15,084 for ORP. The high cost of RARP is attributable to robot purchase, maintenance, and supplies, which was the main factor for limiting its widespread adoption.…”

Section: Fig 2 Pooled Estimates Of Operation Durationmentioning

confidence: 96%

Robot-Assisted Radical Prostatectomy vs. Open Retropubic Radical Prostatectomy for Prostate Cancer: A Systematic Review and Meta-analysis

et al. 2014

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Open retropubic radical prostatectomy (ORP) remains the "gold standard" for surgical treatment of clinically localized prostate cancer (PCa). Robot-assisted radical prostatectomy (RARP) is a robotic surgery used worldwide. The aim of this study is to collect the data available in the literature on RARP and ORP, and further evaluate the overall safety and efficacy of RARP vs. ORP for the treatment of clinically localized PCa. A literature search was performed using electronic databases between January 2009 and October 2013. Clinical data such as operation duration, transfusion rate, positive surgical margins (PSM), nerve sparing, 3-and 12-month urinary continence, and potency were pooled to carry out metaanalysis. Six studies were enrolled for this meta-analysis. The operation duration of RARP group was longer than that of ORP group (weighted mean difference=64.84). There was no statistically significant difference in the transfusion rate, PSM rate, and between RARP and ORP (transfusion rate, OR=0.30; PSM rate, OR=0.94). No significant difference was seen in 3-and 12-month urinary continence recovery (3 months, OR= 1.32; 12 months, OR=1.30). There was a statistically significant difference in potency between the 3-and 12-month groups (3 months, OR=2.80; 12 months, OR=1.70). RARP is a safe and feasible surgical technique for the treatment of clinically localized PCa owing to the advantages of fewer perioperative complications and quicker patency recovery.Keywords Robot-assisted radical prostatectomy . Open retropubic radical prostatectomy . Prostate cancer Abbreviations PCaProstate cancer RP Radical prostatectomy ORP Open retropubic radical prostatectomy RRP Retropubic radical prostatectomy RARP Robot-assisted radical prostatectomy RALP Robot-assisted laparoscopic prostatectomy PSA Prostate-specific antigen NOS Newcastle-Ottawa Scale Xiu-wu Pan and Xin-ming Cui contributed equally to this work.

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“…Dagegen ist WW eine palliative Strategie mit bedarfsorientierter Symptombehandlung, meist durch eine Hormontherapie. Die Wahrscheinlichkeit des gesamt-und des tumorspezifischen Überlebens ist für alle Therapiearten vergleichbar, die mit einzelnen Behandlungsstrategien assoziierten Gesamtkosten variieren jedoch signifikant [6,8,13,15,28]. Nach einer Studie aus den USA reichen die Kosten pro Patient über einen 5-jährigen Nachbeobachtungszeitraum von 7298 US$ unter AS bis hin zu 23.565 US$ bei RT [15].…”

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“…In einer schwedischen Studie wurden bei 12-jähriger Nachsorge 34 % höhere Gesamtkosten nach RP im Vergleich zu WW berichtet [12]. AS wird von anderer Seite als die Option mit den niedrigsten Gesamtkosten über ein 10-Jahres-Follow-up beschrieben [8].…”

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