scholarly journals Cost-effective analysis and budget comparison of laparoscopic radical prostatectomy and robotic-assisted radical prostatectomy for prostate cancer treatment in a health insurance system in Thailand

2021 ◽  
Vol 42 (1) ◽  
pp. 13-20
Author(s):  
Keeree Komvuttikarn ◽  
◽  
Premsant Sangkum ◽  
Wisoot Kongchareonsombat ◽  
Kittinut Kijvikai ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Risk Groups ◽  
Laparoscopic Radical Prostatectomy ◽  
Hospital Charges ◽  
Robotic Assisted ◽  
Related Quality ◽  
Operative Quality

Objectives: To compare the total medical cost and post-operative quality of life between laparoscopic radical prostatectomy (LRP) and robotic-assisted laparoscopic radical prostatectomy (RALP) and to discuss the cost differences of each approach. Materials and Methods: Data were retrospectively reviewed from patients diagnosed with prostate cancer and who underwent LRP (n=68) or RALP (n=104) during a 36-month period. The prostate cancers of all patients were classified as low, intermediate, or high risk. Patient variables, inpatient hospital charges, outpatient total medical costs within 24 months and post-operative quality of life were compared. Results: The baseline patient characteristics were similar between each group. Rates of positive margins and the need for further cancer treatment were correlated with the burden of disease (highest in the high risk group). The RALP inpatient hospital charges were higher in all risk groups. However, the mean total outpatient hospital charges were comparable. The RALP group demonstrated a trend towards better sexual-related quality of life in all risk groups. However, urinary incontinence, urinary-related, bowel-related, vitality-related quality of life were not significantly different between LRP and RALP. Conclusion: From the payer’s perspective, RALP costs are higher than LRP costs. The clinical and quality of life benefits associated with RALP may not convert into a net savings of total medical costs within 24 months after surgery.

scholarly journals Health-Related Quality of Life following Cytoreductive Radical Prostatectomy in Patients with de-novo Oligometastatic Prostate Cancer

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5636
Author(s):  
Michael Chaloupka ◽  
Lina Stoermer ◽  
Maria Apfelbeck ◽  
Alexander Buchner ◽  
Vera Wenter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
De Novo ◽  
Health Related Quality ◽  
Significant Difference ◽  
Related Quality ◽  
Health Related

(1) Background: local treatment of the primary tumor has become a valid therapeutic option in de-novo oligo-metastatic prostate cancer (PC). However, evidence regarding radical prostatectomy (RP) in this setting is still subpar, and the effect of cytoreductive RP on postoperative health-related quality of life (HRQOL) is still unclear. (2) Methods: for the current study, patients with de-novo oligo-metastatic PC (cM1-oligo), defined as ≤5 bone lesions in the preoperative staging, were included, and matched cohorts using the variables age, body-mass index (BMI), and pT-stage were generated. Patient-reported outcome measures (PROMS) were assessed pre- and postoperatively using the validated EORTC-QLQ-C30, IIEF-5, and ICIQ-SF questionnaires. The primary endpoint for univariate and multivariable analysis was good general HRQOL defined by previously validated cut-off values. (3) Results: in total, 1268 patients (n = 84 (7%) cM1-oligo) underwent RP between 2012 and 2020 at one tertiary care center. A matched cohort of 411 patients (n = 79 with oligo-metastatic bone disease (cM1-oligo) and n = 332 patients without clinical indication of metastatic disease (cM0)) was created. The median follow-up was 25mo. There was no significant difference in good general HRQOL rates between cM1-oligo-patients and cM0-patients before RP (45.6% vs. 55.2%, p = 0.186), and at time of follow-up (44% vs. 56%, p = 0.811). Global health status (GHS) worsened significantly in cM0-patients compared to baseline (−5, p = 0.001), whereas GHS did not change significantly in cM1-oligo-patients (+3.2, p = 0.381). In multivariate analysis stratified for good erectile function (IIEF5 > 18; OR 5.722, 95% CI 1.89–17.36, p = 0.002) and continence recovery (OR 1.671, 95% CI 1.03–2.70, p = 0.036), cM1-oligo was not an independent predictive feature for general HRQOL (OR 0.821, 95% CI 0.44–1.53, p = 0.536). (4) Conclusions: in this large contemporary retrospective analysis, we observed no significant difference in HRQOL in patients with the oligometastatic bone disease after cytoreductive radical prostatectomy, when compared to patients with localized disease at time of surgery.

Quality of Life Following Management of Localized Prostate Cancer

2018 ◽  
Author(s):  
Louis A Aliperti ◽  
Martin G Sanda ◽  
Christopher P Filson
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Expectant Management ◽  
Diagnosis And Treatment ◽  
Urinary Tract Symptoms ◽  
Related Quality ◽  
Health Related ◽  
The Impact

With a long survivorship phase after diagnosis and treatment of prostate cancer, consideration of the impact of treatment on health-related quality of life (HRQOL) is critical. For men considering treatment of prostate cancer, the domains that are impacted include urinary, sexual, and bowel-related qualities of life. This review identifies aspects of tools measuring HRQOL and covers instruments used to measure quality of life following a diagnosis and treatment of prostate cancer. We review the impact associated with radical prostatectomy, radiation and brachytherapy, and observation on men diagnosed with prostate cancer and compare the effects that each management strategy has on sexual and urinary function. This review contains 3 figures, 5 tables, 44 references. Key Words: erectile dysfunction, expectant management, lower urinary tract symptoms, prostate cancer, radical prostatectomy, radiation therapy, quality of life, urinary incontinence

scholarly journals Incontinence and Erectile Dysfunction Following Radical Prostatectomy: A Review

2005 ◽  
Vol 5 ◽  
pp. 747-758 ◽  
Author(s):  
Gerasimos Alivizatos ◽  
Andreas Skolarikos
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Erectile Dysfunction ◽  
Radical Prostatectomy ◽  
Surgical Technique ◽  
Localized Prostate Cancer ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Radical prostatectomy remains the treatment of choice for localized prostate cancer in age-appropriate and health-appropriate men. Although cancer control is the most important aspect of a radical prostatectomy, minimization of postoperative morbidity, especially urinary incontinence and erectile dysfunction, is becoming a greater concern. We reviewed recent data available on Medline regarding the incidence, pathophysiology, evaluation, and treatment of incontinence and sexual dysfunction after radical prostatectomy. Health-related quality of life issues have been specifically addressed. Although low incidences of incontinence and erectile dysfunction after radical prostatectomy have been reported in the hands of experienced surgeons, the literature review revealed a great variety, with incontinence rates ranging from 0.3–65.6% and potency rates ranging from 11–87%. Several factors contribute to this wide difference, the most important being the application of a meticulous surgical technique. General and cancer-specific health-related quality of life is not being affected after radical prostatectomy. The incidence of incontinence and erectile dysfunction is higher after radical prostatectomy when compared to the incidence observed when other therapies for localized prostate cancer are applied. However, the majority of the patients undergoing radical prostatectomy would vote for the operation again. Today, avoidance of major complications after radical prostatectomy depends mostly on a high-quality surgical technique. When incontinence or erectile dysfunction persists after radical prostatectomy, the majority of the treated patients can be managed effectively by various methods.

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