Costs of medical care after open or minimally invasive prostate cancer surgery: A population-based analysis Journal Article

Authors: Lowrance, W. T.; Eastham, J. A.; Yee, D. S.; Laudone, V. P.; Denton, B.; Scardino, P. T.; Elkin, E. B.
Article Title: Costs of medical care after open or minimally invasive prostate cancer surgery: A population-based analysis
Abstract: BACKGROUND: Evidence suggests that minimally invasive radical prostatectomy (MRP) and open radical prostatectomy (ORP) have similar short-term clinical and functional outcomes. MRP with robotic assistance is generally more expensive than ORP, but it is not clear whether subsequent costs of care vary by approach. METHODS: In the Surveillance, Epidemiology, and End Results (SEER) cancer registry linked with Medicare claims, men aged 66 years or older who received MRP or ORP in 2003 through 2006 for prostate cancer were identified. Total cost of care was estimated as the sum of Medicare payments from all claims for hospital care, outpatient care, physician services, home health and hospice care, and durable medical equipment in the first year from the date of surgical admission. The impact of surgical approach on costs was estimated, controlling for patient and disease characteristics. RESULTS: Of 5445 surgically treated prostate cancer patients, 4454 (82%) had ORP and 991 (18%) had MRP. Mean total first-year costs were more than $1200 greater for MRP compared with ORP ($16,919 vs $15,692; P = .08). Controlling for patient and disease characteristics, MRP was associated with 2% greater mean total payments, but this difference was not statistically significant. First-year costs were greater for men who were older, black, lived in the Northeast, had lymph node involvement, more advanced tumor stage, or greater comorbidity. CONCLUSIONS: In this population-based cohort of older men, MRP and ORP had similar economic outcomes. From a payer's perspective, any benefits associated with MRP may not translate to net savings compared with ORP in the first year after surgery. © 2011 American Cancer Society.
Keywords: cancer chemotherapy; controlled study; aged; aged, 80 and over; major clinical study; advanced cancer; united states; cancer radiotherapy; cancer staging; antineoplastic agent; laparoscopy; prostate specific antigen; cohort analysis; bisphosphonic acid derivative; age; prostate cancer; gleason score; prostatic neoplasms; hospital care; drug cost; health care cost; health service; medical instrumentation; medicare; prostate; preoperative period; prostatectomy; lymph node; comorbidity; scoring system; cancer registry; minimally invasive surgery; robotics; antiandrogen; home care; health care costs; medical care; outpatient care; african american; income; caucasian; geography; race; hospice care; minimally invasive radical prostatectomy; open radical prostatectomy; charlson comorbidity score; minimally invasive surgical procedures
Journal Title: Cancer
Volume: 118
Issue: 12
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2012-06-15
Start Page: 3079
End Page: 3086
Language: English
DOI: 10.1002/cncr.26609
PROVIDER: scopus
PUBMED: 22025192
PMCID: PMC3480340
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 2 July 2012" - "CODEN: CANCA" - "Source: Scopus"
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MSK Authors
  1. Brian Denton
    10 Denton
  2. Vincent Laudone
    59 Laudone
  3. Peter T Scardino
    621 Scardino
  4. Elena B Elkin
    149 Elkin
  5. David Scott Yee
    19 Yee
  6. James Eastham
    426 Eastham