Author : Surbhi Shah
Publisher :
ISBN 13 :
Total Pages : 248 pages
Book Rating : 4.:/5 (1 download)
Book Synopsis Comparative Effectiveness and Costs of Conservative Management and Cryotherapy in Patients with Localized Prostate Cancer by : Surbhi Shah
Download or read book Comparative Effectiveness and Costs of Conservative Management and Cryotherapy in Patients with Localized Prostate Cancer written by Surbhi Shah and published by . This book was released on 2017 with total page 248 pages. Available in PDF, EPUB and Kindle. Book excerpt: Prostate cancer is the second leading cause of death in American Men. Nearly, 4 out of 5 cases are diagnosed with localized prostate cancer. Although, several treatment options are available to treat localized prostate cancer, there is insufficient evidence on long term outcomes associated with these treatments. Therefore, the purpose of this study was to assess treatment related side-effects, cancer specific survival, rates of mental health issues including depression and anxiety disorder, and costs associated with conservative management and cryotherapy in patients with localized prostate cancer. This retrospective longitudinal study design utilized Surveillance, Epidemiology, and Ends Results (SEER)-Medicare linked data set from 2000 -2013. Patients' aged 66 years or older with stage I and stage II cancer diagnosis were included in the study. Patients in the CM cohort were identified as those who did not receive any immediate treatment within 6 months of diagnosis of localized prostate cancer. Patients in the cryotherapy cohort were identified using ICD-9 procedure code, Healthcare Common Procedure Coding System (HCPCS) code/Current Procedural Terminology (CPT) code. The ICD-9 diagnosis and procedure codes were used to identify treatment related side-effects (Erectile dysfunction, lower urinary tract obstruction, bowel fistula, urinary fistula, urinary incontinence, bleeding and hydronephrosis), and mental health issues (major depressive disorder, depressive disorder NOS, neurotic depression, adjustment disorder with depressed mood, and anxiety disorder). Medicare claims information was utilized to evaluate costs. The date of diagnosis and date of death was used to assess cancer specific survival. There were 7,998 and 3,051 patients identified in the conservative management and cryotherapy cohorts, respectively. Findings suggest that the rates of side-effects, and depression and anxiety disorders were lower in patients who choose conservative management over cryotherapy. Cancer specific survival rates were also found to be higher in patients in the conservative management cohort compared to cryotherapy. The total mean cost, mean annual cost and phase specific costs were found to be lower in the conservative management cohort. Overall, conservative management was found to be a better treatment strategy in older patients with localized prostate cancer.