Financial Comparative Analysis of Minimally Invasive Surgery to Open Surgery for Localized Prostate Cancer: A Single-Institution Experience

Mouraviev, Vladimir; Nosnik, Israel; Sun, Leon; Robertson, Cary N.; Walther, Philip; Albala, David; Moul, Judd W.; Polascik, Thomas J.

doi:10.1016/j.urology.2006.10.025

Cited by 77 publications

(62 citation statements)

References 6 publications

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“…Given the large number of men with prostate cancer, the effects of treatment have major public health implications, including patient counseling and financial costs. The existing studies comparing the costs of robotic and open radical prostatectomy, however, are limited in their scope, addressing only the costs of the procedure and initial hospital stay[40,41,42]. These studies do not consider subsequent costs from complications, treatment of side effects, or cancer recurrence, which may be substantial in this patient population.…”

Section: Comparison and Discussion Of Orp And Ralpmentioning

confidence: 99%

“…Cost studies by Lotan et al, Mouraviev et al, Scales et al, and Bolenz et al specifically compared RALP with ORP and reported higher operative costs with RALP, although comparisons were restricted to the costs of the procedure and the duration of initial hospitalization[40,41,42,43]. Scales et al reported that inpatient costs of RALP are volume dependent and that cost equivalence with ORP is possible at high-volume specialty centers; however, they do not report actual cost data[42].…”

Section: Comparison and Discussion Of Orp And Ralpmentioning

confidence: 99%

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Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Lowrance

Tarin

Shariat

2010

The Scientific World JOURNAL

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The rapid adoption of robotic-assisted laparoscopic radical prostatectomy (RALP) has occurred despite a lack of high-quality evidence demonstrating its oncologic advantages, safety, or cost effectiveness compared with open radical retropubic prostatectomy (ORP). This review examines the current literature comparing ORP and RALP, focusing on perioperative, oncologic, functional, and economic outcomes.

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Section: Comparison and Discussion Of Orp And Ralpmentioning

confidence: 99%

Section: Comparison and Discussion Of Orp And Ralpmentioning

confidence: 99%

Evidence-Based Comparison of Robotic and Open Radical Prostatectomy

Lowrance

Tarin

Shariat

2010

The Scientific World JOURNAL

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“…Two studies have reported higher costs during hospital stay for RALP compared with RRP [1,2], whereas another study has suggested lower total costs for RALP, although higher direct costs [3]. A valid comparison of the costs for the two techniques cannot be done, because the calculations are based on different models [13].…”

Section: Discussionmentioning

confidence: 99%

Open retropubic prostatectomy versus robot-assisted laparoscopic prostatectomy: A comparison of length of sick leave

Hohwü

Akre

Pedersen

et al. 2009

Scandinavian Journal of Urology and Nephrology

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Objective. It remains uncertain whether the increased direct costs of robot-assisted laparoscopic radical prostatectomy (RALP) are outweighed by cost savings due to shorter postoperative hospital care and shorter sick leave. This study compared the length of sick leave after RALP with that after radical retropubic prostatectomy (RRP). Material and methods. In a cohort study, information on length of sick leave was retrieved for 274 working men undergoing radical prostatectomy (127 RALP and 147 RRP). Data on confounders such as physical workload, average salary, body mass index and disease characteristics were collected from the medical records. Cox regression models were used to compare the treatment groups. Results. The median number of days with sick leave was 11 in the RALP group and 49 in the RRP group. After adjustment for confounders, patients in the RALP group were twice as likely to return to work at any time during follow-up (hazard ratio 02.13, 95% confidence interval 1.62Á2.80). High physical workload, low salary and high tumour grade were more common in the RRP group and associated with longer sick leave. Conclusions. Patients in the RALP group had shorter postoperative hospital stay and less need for paid sick leave than patients in the RRP group. These data indicate that RALP shortens the convalescence. Part of this difference may, however, be attributable to different selection of patients and different a priori expectations among patients and their doctors. A prospective randomized study is advocated, although blinding is unfeasible.

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“…Partial gland cryoablation has yielded 75.7% to 84% biochemical recurrence-free rates, 98.4% to 100% urinary continence, 86% sexual potency, and 75% negative biopsies [55,58,59]. While cryotherapy is a more expensive surgical procedure than radical prostatectomy, the overall direct costs of cryotherapy ($9,195) are less than radical prostatectomy ($10,704), due to shorter hospital stays, lack of pathologic costs, and the absence of the need for blood transfusions [60].…”

Section: Future Treatment Modalities Targeted Focal Therapymentioning

confidence: 99%