A comprehensive analysis of cost of an active surveillance cohort compared to radical prostatectomy as primary treatment for prostate cancer.
World J Urol
; 37(7): 1297-1303, 2019 Jul.
Article
em En
| MEDLINE
| ID: mdl-30276542
ABSTRACT
INTRODUCTION:
Active surveillance (AS) seems to be a cost-effective strategy. However, most publications are based on simulation models of theoretical cohorts, and long-term implications are not usually considered.OBJECTIVE:
To assess the real cost differences of two cohorts of men with low-risk prostate cancer (PCa) treated with AS or laparoscopic radical prostatectomy (LRP) in a public health system. MATERIALS ANDMETHODS:
Patients diagnosed from 2005 to 2009 were included in an AS program (Group 1) or treated with LRP at diagnosis (Group 2), with a minimum follow-up of 5 years. Actual costs for each patient were calculated on an individual basis Group 1 semiannual PSA measurements and repeat biopsies are scheduled every 1-3 years. Costs of outpatient clinic visits were calculated, as well as all tests required for monitoring or active treatment. Group 2 costs of the procedure, emergency visits, re-admissions and outpatient clinic visits were calculated, as well as costs of oncological salvage therapies or functional surgical procedures.RESULTS:
Out of 151 men diagnosed with low-risk PC, 54 (35.8%) were included in an AS (Group 1) and 97 (64.2%) were submitted to LRP (Group 2). Mean follow-up for both groups was 6.5 years (SD 1.8) and 6.7 years (SD 1.4), respectively, p = 0.49. Group 1 had a total cost per patient of 2970.47. Group 2 had a total cost per patient of 5694.06.CONCLUSIONS:
AS was associated with cost-saving over LRP. This cost reduction of AS in the management of low-risk PCa is based on the accounting of real costs of individual patients and confirms previously published estimation-based reports.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Prostatectomia
/
Neoplasias da Próstata
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Custos de Cuidados de Saúde
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Conduta Expectante
Tipo de estudo:
Health_economic_evaluation
/
Risk_factors_studies
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Screening_studies
Limite:
Aged
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
World J Urol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Espanha