Comparing the costs of radiation therapy and radical prostatectomy for the initial treatment of early-stage prostate cancer
Comparing the costs of radiation therapy and radical prostatectomy for the initial treatment of early-stage prostate cancer
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DOI：
10.1200/jco.2002.11.136
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发表时间：
2002-06-15
影响因子：
45.3
通讯作者：
Hayman, JA
中科院分区：
文献类型：
--
作者：
Burkhardt, JH;Litwin, MS;Hayman, JA
目的：根治性前列腺切除术和外照射是局限性前列腺癌最常见的治疗方法。鉴于缺乏支持一种治疗或另一种治疗的临床共识，相对成本可能是一个重要因素。本研究比较了早期前列腺癌主要接受外照射放疗或根治性前列腺切除术治疗的患者在诊断前一个月和诊断后 9 个月的直接医疗费用。方法：确定了 1992 年和 1993 年期间主要接受外照射放疗或根治性前列腺切除术治疗的 65 岁或以上且由监测、流行病学和最终结果 (SEER) 登记处编码为已诊断为前列腺癌的患者。在调整合并症和年龄的差异后，使用链接的 SEER-Medicare 索赔数据对每种策略的初始治疗成本（以 Medicare 批准的支付金额衡量）进行分析。还进行了意向治疗分析，以调整两组之间的分期差异。结果：对于接受治疗分析的患者，平均费用显着不同，放射治疗的平均费用为 14,048 美元（95% 置信区间 [Cl]，13,765 美元至 14,330 美元），根治性前列腺切除术为 17,226 美元（95% CI，16,891 美元至 17,560 美元）（P
Purpose: Radical prostatectomy and external-beam radiation are the most common treatments for localized prostate cancer. Given the absence of clinical consensus in favor of one treatment or the other, relative costs may be a significant factor. This study compares the direct medical costs during the month before and 9 months after diagnosis for patients treated primarily with external-beam radiation or radical prostatectomy for early-stage prostate cancer.Methods: Patients age 65 or older and coded by the Surveillance, Epidemiology, and End Results (SEER) registry as having been diagnosed with adenocarcinoma of the prostate treated primarily with external-beam radiation or radical prostatectomy during 1992 and 1993 were identified. The initial treatment costs, as measured by Medicare-approved payment amounts, for each strategy were analyzed using linked SEER-Medicare claims data after adjusting for differences in comorbidity and age. An intent-to-treat analysis was also performed to adjust for differences in staging between the two groups.Results: For patients in the treatment-received analysis, the average costs were significantly different, $14,048 (95% confidence interval [Cl], $13,765 to $14,330) for radiation therapy and $17,226 (95% Cl, $16,891 to $17,560) for radical prostatectomy (P