Víctor Zamora, Guillermo Bosch, Virginia Becerra, Olatz Garin, Mónica Ávila, Cristina Gutiérrez, José Francisco Suárez, Alai Goñi, Víctor Macías, Alfonso Mariño, Asunción Hervás, Ismael Herruzo, Patricia Cabrera, Javier Ponce de León, Gemma Sancho, Àngels Pont, Maria Rubio-Valera, Jordi Alonso, Francesc Cots, Ferran Guedea, Manuel Castells, Montse Ferrer, the Multicentric Spanish Group of Clinically Localized Prostate Cancer
{"title":"局限性前列腺癌传统治疗方法的经济评价：一项10年队列研究","authors":"Víctor Zamora, Guillermo Bosch, Virginia Becerra, Olatz Garin, Mónica Ávila, Cristina Gutiérrez, José Francisco Suárez, Alai Goñi, Víctor Macías, Alfonso Mariño, Asunción Hervás, Ismael Herruzo, Patricia Cabrera, Javier Ponce de León, Gemma Sancho, Àngels Pont, Maria Rubio-Valera, Jordi Alonso, Francesc Cots, Ferran Guedea, Manuel Castells, Montse Ferrer, the Multicentric Spanish Group of Clinically Localized Prostate Cancer","doi":"10.1155/ecc/3563061","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Objectives:</b> To perform a cost-effectiveness analysis based on primary data from a cohort of patients with localized prostate cancer followed throughout 10 years, comparing radical prostatectomy, brachytherapy, and external beam radiotherapy (EBRT) and applying disease-specific utilities, from a national health system’s perspective.</p>\n <p><b>Materials and Methods:</b> Patients diagnosed with localized prostate cancer were consecutively recruited in 2003–2005 from 10 Spanish hospitals (<i>n</i> = 674) (ClinicalTrials.gov number: NCT01492751). The expanded prostate cancer index composite (EPIC) and short-form 36 (SF-36) questionnaires were administered through telephone interviews before treatment and annually during follow-up. The outcome measures to evaluate the incremental cost-effectiveness ratio between treatments (ICER) were quality-adjusted life-years (QALYs), calculated by the patient-oriented prostate utility scale (PORPUS) utility index, obtained with a mapping from the EPIC and the SF-36, and survival data. Ten-year medical activities were used to derive costs. Both unweighted and propensity score-weighted analyses were performed.</p>\n <p><b>Results:</b> The weighted mean of 10-year QALYs was the highest for radical prostatectomy (8.53), followed by brachytherapy (8.49) and external radiotherapy (8.20), but the difference was only statistically significant with the latter. Costs were significantly higher for brachytherapy (€21,348) than radical prostatectomy (€12,281) and EBRT (€7,560). Compared to EBRT, the weighted ICER for radical prostatectomy was €14,169/QALY gained and €48,417/QALY for brachytherapy.</p>\n <p><b>Conclusion:</b> Our findings support that radical prostatectomy was the most cost-effective alternative, but the differences in effectiveness among the three treatments were small. The incremental cost of radical prostatectomy and brachytherapy compared to EBRT, however, does not justify restricting these alternatives.</p>\n <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT01492751</p>\n </div>","PeriodicalId":11953,"journal":{"name":"European Journal of Cancer Care","volume":"2025 1","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/3563061","citationCount":"0","resultStr":"{\"title\":\"Economic Evaluation of Traditional Treatments for Localized Prostate Cancer: A 10-Year Cohort Study\",\"authors\":\"Víctor Zamora, Guillermo Bosch, Virginia Becerra, Olatz Garin, Mónica Ávila, Cristina Gutiérrez, José Francisco Suárez, Alai Goñi, Víctor Macías, Alfonso Mariño, Asunción Hervás, Ismael Herruzo, Patricia Cabrera, Javier Ponce de León, Gemma Sancho, Àngels Pont, Maria Rubio-Valera, Jordi Alonso, Francesc Cots, Ferran Guedea, Manuel Castells, Montse Ferrer, the Multicentric Spanish Group of Clinically Localized Prostate Cancer\",\"doi\":\"10.1155/ecc/3563061\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><b>Objectives:</b> To perform a cost-effectiveness analysis based on primary data from a cohort of patients with localized prostate cancer followed throughout 10 years, comparing radical prostatectomy, brachytherapy, and external beam radiotherapy (EBRT) and applying disease-specific utilities, from a national health system’s perspective.</p>\\n <p><b>Materials and Methods:</b> Patients diagnosed with localized prostate cancer were consecutively recruited in 2003–2005 from 10 Spanish hospitals (<i>n</i> = 674) (ClinicalTrials.gov number: NCT01492751). The expanded prostate cancer index composite (EPIC) and short-form 36 (SF-36) questionnaires were administered through telephone interviews before treatment and annually during follow-up. The outcome measures to evaluate the incremental cost-effectiveness ratio between treatments (ICER) were quality-adjusted life-years (QALYs), calculated by the patient-oriented prostate utility scale (PORPUS) utility index, obtained with a mapping from the EPIC and the SF-36, and survival data. Ten-year medical activities were used to derive costs. Both unweighted and propensity score-weighted analyses were performed.</p>\\n <p><b>Results:</b> The weighted mean of 10-year QALYs was the highest for radical prostatectomy (8.53), followed by brachytherapy (8.49) and external radiotherapy (8.20), but the difference was only statistically significant with the latter. Costs were significantly higher for brachytherapy (€21,348) than radical prostatectomy (€12,281) and EBRT (€7,560). 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The incremental cost of radical prostatectomy and brachytherapy compared to EBRT, however, does not justify restricting these alternatives.</p>\\n <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT01492751</p>\\n </div>\",\"PeriodicalId\":11953,\"journal\":{\"name\":\"European Journal of Cancer Care\",\"volume\":\"2025 1\",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-07-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/ecc/3563061\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Journal of Cancer Care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/ecc/3563061\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Cancer Care","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/ecc/3563061","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Economic Evaluation of Traditional Treatments for Localized Prostate Cancer: A 10-Year Cohort Study
Objectives: To perform a cost-effectiveness analysis based on primary data from a cohort of patients with localized prostate cancer followed throughout 10 years, comparing radical prostatectomy, brachytherapy, and external beam radiotherapy (EBRT) and applying disease-specific utilities, from a national health system’s perspective.
Materials and Methods: Patients diagnosed with localized prostate cancer were consecutively recruited in 2003–2005 from 10 Spanish hospitals (n = 674) (ClinicalTrials.gov number: NCT01492751). The expanded prostate cancer index composite (EPIC) and short-form 36 (SF-36) questionnaires were administered through telephone interviews before treatment and annually during follow-up. The outcome measures to evaluate the incremental cost-effectiveness ratio between treatments (ICER) were quality-adjusted life-years (QALYs), calculated by the patient-oriented prostate utility scale (PORPUS) utility index, obtained with a mapping from the EPIC and the SF-36, and survival data. Ten-year medical activities were used to derive costs. Both unweighted and propensity score-weighted analyses were performed.
Results: The weighted mean of 10-year QALYs was the highest for radical prostatectomy (8.53), followed by brachytherapy (8.49) and external radiotherapy (8.20), but the difference was only statistically significant with the latter. Costs were significantly higher for brachytherapy (€21,348) than radical prostatectomy (€12,281) and EBRT (€7,560). Compared to EBRT, the weighted ICER for radical prostatectomy was €14,169/QALY gained and €48,417/QALY for brachytherapy.
Conclusion: Our findings support that radical prostatectomy was the most cost-effective alternative, but the differences in effectiveness among the three treatments were small. The incremental cost of radical prostatectomy and brachytherapy compared to EBRT, however, does not justify restricting these alternatives.
期刊介绍：
The European Journal of Cancer Care aims to encourage comprehensive, multiprofessional cancer care across Europe and internationally. It publishes original research reports, literature reviews, guest editorials, letters to the Editor and special features on current issues affecting the care of cancer patients. The Editor welcomes contributions which result from team working or collaboration between different health and social care providers, service users, patient groups and the voluntary sector in the areas of:
- Primary, secondary and tertiary care for cancer patients
- Multidisciplinary and service-user involvement in cancer care
- Rehabilitation, supportive, palliative and end of life care for cancer patients
- Policy, service development and healthcare evaluation in cancer care
- Psychosocial interventions for patients and family members
- International perspectives on cancer care
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