膀胱癌的发病率、医疗途径和经济负担：来自法国国家医疗保健系统数据库的现实世界观察性研究

IF 2.3 3区医学 Q3 ONCOLOGY

Clinical genitourinary cancer Pub Date : 2025-04-02 DOI:10.1016/j.clgc.2025.102344

Aldéric Masoandro Fraslin , Simone Benhamou , Thierry Lebret , François Radvanyi , Yves Allory , Maryam Karimi , Julia Bonastre

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引用次数: 0

摘要

目的评估法国膀胱癌（BC）的发病率（所有病变），描述患者特征和诊断后第一年的医疗途径，并估计医疗费用。方法从法国国家卫生保健系统数据库中选择2017年所有首次诊断为BC （ICD-10代码：C67， D09.0, D41.4）的成人患者。患者根据他们所接受的最具侵入性的外科手术进行分类。治疗包括膀胱切除术、经尿道膀胱肿瘤切除术（TURBT）、膀胱内治疗、化疗和放疗。医疗保健途径按序列进行分析，并使用分层聚类进行分组。对每组患者发病第一年的医疗费用进行了估计。结果在入选的24,737例BC患者中，诊断时的中位年龄为72岁，80.2%为男性。近20%的人在前一年接受过除BC以外的癌症治疗。大多数（n = 9501, 38.4%）仅接受TURBT治疗，平均医疗费用为4435欧元[95% CI: 4322；4548]。共有3037例患者（12.3%）接受膀胱切除术作为初始治疗。单次TURBT后接受膀胱内滴注的组的估计费用(€6129 [5994；6264])低于重复TURBT组(€9357 [9086；9628])。膀胱切除术后接受全身治疗的患者费用最高，为25,636欧元[24,519；26752]。结论：我们的研究估算了法国BC的发病率，描述了国家层面的医疗保健途径，并分析了相关的经济负担。

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Incidence of Bladder Cancer, Healthcare Pathways, and Economic Burden: A Real-World Observational Study From the French National Healthcare System Database

Purpose

To assess the incidence (all lesions) of bladder cancer (BC) in France, describe patient characteristics and healthcare pathways during the first year after diagnosis, and estimate medical costs.

Methods

All adult patients with an initial BC diagnosis (ICD-10 codes: C67, D09.0, D41.4) in 2017 were selected from the French National Healthcare System Database. Patients were classified according to the most invasive surgical procedure they underwent. Treatments included cystectomy, transurethral resection of bladder tumor (TURBT), intravesical therapy, chemotherapy, and radiotherapy. Healthcare pathways were analyzed as sequences and grouped using hierarchical clustering. Medical costs during the first year of the disease were estimated for each cluster.

Results

Out of 24,737 incident BC patients selected, the median age at diagnosis was 72 years, and 80.2% were men. Nearly 20% had received treatment for a cancer other than BC in the previous year. The majority (n = 9501, 38.4%) underwent TURBT only with a mean medical cost of €4435 [95% CI: 4322; 4548]. A total of 3037 patients (12.3%) underwent cystectomy as their initial treatment. The estimated costs for the group receiving intravesical instillations following a single TURBT (€6129 [5994; 6264]) were lower than those for the group with repeated TURBT (€9357 [9086; 9628]). Costs for patients who received systemic treatment after cystectomy were the highest at €25,636 [24,519; 26,752].

Conclusion

Our study estimates the incidence of BC in France, describes healthcare pathways at the national level, and analyses the associated economic burden.

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来源期刊

Clinical genitourinary cancer 医学-泌尿学与肾脏学

CiteScore

5.20

自引率

6.20%

发文量

201

审稿时长

54 days

期刊介绍： Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.