Search is Powered by Google
Follow us on:
Follow our health news on Twitter
Follow Our News on Facebook
Personalization
login | register
Urology / Nephrology News

Routine Perioperative Chemotherapy Instillation With Initial Transurethral Resection: A Cross Examination Of Economic Benefits

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology
Article Date: 29 Jun 2008 - 0:00 PDT

email icon email to a friend   printer icon printer friendly   write icon view / write opinions   rate icon rate article


Current Article Ratings:

Patient / Public:not yet rated

Health Professional:not yet rated

Article Opinions: 0 posts

ORLANDO, FL (UroToday.com) - Indisputable level-one evidence has demonstrated decreased recurrence rates of low-grade (LG) bladder tumors when initial bladder tumor resection is followed by chemotherapeutic perioperative instillation (PI). A meta-analysis found 8.5 patients to be the number needed to treat (NNT) to prevent one bladder tumor recurrence, however patients with no tumor were excluded from the analysis thus underestimating the true NNT.

In addition, it has been suggested that routine PI would be economically prudent, but no calculation of actual treatment costs was presented to validate this claim. The authors analyzed the economics of PI with the goal of determining the NNT, and determining the actual costs and alternative management options.

The reimbursements made by Medicare for PI, and those for tumor management in different settings (i.e. hospital inpatient, ambulatory surgery center (ASC), physicians office) at the Cleveland Clinic were examined. 9.6 patients need to be treated (NNT) to prevent one tumor recurrence. With procedural and pharmacy costs, PI adds > $201.39 to the cost of initial transurethral resection (TUR). The cost of treating 9.6 patients with PI adds > $1933 to the cost of the initial TURs. This is indeed less than the cost of managing one recurrence with hospital inpatient TUR ($4680.58), suggesting an economic benefit to routine PI.

However, the cost to treat 9.6 patients with PI is greater than the cost of outpatient TUR in the hospital ($1813.53), office fulguration ($1251.45), or TUR in the ASC ($680.43). In our model, if > 69% of all recurrences were managed as outpatients with TUR in the ASC rather than inpatient hospital TUR, then the economic benefit of PI would be fully offset.

The authors conclude that although PI decreases low grade bladder tumor recurrence, our model suggests that the economic impact of PI is limited in the USA. For PI to be economically sound, treatment of recurrent non-invasive bladder cancer should be outside the hospital and either in a surgery center or physician's office.

Presented by Pravin K Rao, MD, J Stephen Jones, MD, at the Annual Meeting of the American Urological Association (AUA) - May 17 - 22, 2008. Orange County Convention Center - Orlando, Florida, USA.

Reported by UroToday.com Contributing Editor David P. Wood, MD

UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to: www.urotoday.com

Copyright © 2008 - UroToday




Personalized Homepage Weekly Newsletters Daily News Alerts
Hemophilia Opioid Induced Constipation Pneumococcal Disease ADHD Anxiety Asthma Atrial Fibrillation Autism Cancer Diabetes Lung Cancer Lupus Medicare / Medicaid Obesity and BMI Pancreatic Cancer Stem Cells All 'What Is...' Articles

Ophthalmology Urology
About Us News Licensing Free Website Feeds Free Tools & Content Tell a Friend Accessibility Help / FAQ Article Submission Links Contact Us

add medical news today to your facebook
medical news gadget

Please fill in our survey

Swine Flu Image

Swine Flu Updates

- Latest Swine Flu News
- What is Swine Flu?
- Map Of H1N1 Outbreaks
- Swine Flu - Top 20 FAQ
- Daily Email News Alerts
Stick with Medical News Today for the latest news updates on swine flu.


These are the most read articles from this news category for the last 6 months:
Top Article Star
What Is Dialysis? What Is Kidney Dialysis?
07 Jun 2009
Dialysis is the artificial process of getting rid of waste (diffusion) and unwanted water (ultrafiltration) from the blood. This process is naturally done by our kidneys. Some people, however, may have failed or damaged...


Talking with Your Doctor image Talking with Your Doctor

Talking with your doctor can sometimes be difficult. Good health care, however, depends on an open dialogue between patients and doctors...

Talking with Your Doctor image Talking with Your Doctor

Talking with your doctor can sometimes be difficult. Good health care, however, depends on an open dialogue between patients and doctors...

View more videos...