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Study Compares Prostate Cancer Treatments by Cost and Effectiveness

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Most cost-effective type of prostate cancer therapy is surgery

Researchers at University of California San Francisco recently released comprehensive retrospective study results comparing the major types of prostate cancer treatments in terms of saving lives and cost-effectiveness.

The study analyzed 232 papers published in the last decade that report results from clinical studies involving patients with low-, intermediate-, and high-risk forms of localized prostate cancer. Patients were treated with 1 or more of the standard treatments: radiation therapy, surgery, hormone therapies, and brachytherapy.

Study results, published in the British Journal of Urology International, show that, with the various forms of treatment, terms of survival for people with low-risk prostate cancer vary only slightly. With a 5-year cancer-specific survival rate of nearly 100%, the odds are quite good for men with low-risk prostate cancer. However, researchers found that the cost of radiation therapy is significantly more expensive than surgery for patients with low-risk prostate cancer.

Survival and cost generally favored surgery over other forms of treatment for intermediate- and high-risk prostate cancers. However, combination external beam radiation and brachytherapy together were comparable in terms of quality-of-life–adjusted survival for high-risk prostate cancer.

Lead researcher, urologist Matthew Cooperberg, MD, MPH, said, “Our findings support a greater role for surgery for high-risk disease than we have generally seen it used in most practice settings.” Yet, from one treatment center to another, therapy plans for localized prostate cancer often vary dramatically. “There is very little solid evidence that one [approach] is better than another,” said Cooperberg.

The new study was also a comprehensive cost analysis. Researchers compared the costs and outcomes related to the numerous types of treatment for all forms prostate cancer. These treatments ranged from robot-assisted prostatectomy to treat low-risk disease at $19,901 to combined radiation therapy for high-risk disease at $50,276.

According to Cooperberg, the study did not consider 2 other approaches for dealing with prostate cancer: active surveillance and proton therapy.

Source: UCSF.