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  1. Adjuvant radiation versus observation : A cost analysis of alternate management schemes in early-stage testicular seminoma.

    Article - En anglais

    Purpose 

    This study was designed to compare costs of adjuvant radiation versus observation in the management of early-stage testicular seminoma after inguinal orchiectomy.

    Materials and Methods 

    A line-by-line inspection of the charges generated during a course of adjuvant pelvic and paraaortic radiotherapy and of three cycles of bleomycin, etoposide, and platinum salvage chemotherapy was performed for five patients who received irradiation and five patients who received salvage chemotherapy.

    The average charge for either treatment was then calculated.

    Only those charges directly associated with the diagnosis of seminoma were included in the analysis.

    Follow-up charges were also generated from the patients'billing records.

    The optimum follow-up regimen for either management option was derived from a synthesis of the international literature.

    A 5% rate of failure was assumed if adjuvant irradiation was administered, and a 15% rate of failure was assumed if observation was the option chosen.

    Charges were truncated at 5 years.

    Results 

    The total charge generated over 5 years based on following a policy of observation is $27,223 per patient versus $19,557 if the option of adjuvant irradiation in chosen.

    Using University of Wisconsin institutional reimbursement rates, the estimated costs were $20,487 and $14,722 for the option of observation and adjuvant radiation, respectively.

    The cost equivalence point between the two options occurs at 2. (...)

    Mots-clés Pascal : Séminome, Testicule, Homme, Radiothérapie, Traitement adjuvant, Postopératoire, Analyse coût, Etude longitudinale, Stade précoce, Orchidectomie, Appareil génital mâle pathologie, Testicule pathologie, Tumeur maligne, Chirurgie, Economie santé

    Mots-clés Pascal anglais : Seminoma, Testicle, Human, Radiotherapy, Adjuvant treatment, Postoperative, Cost analysis, Follow up study, Early stage, Orchidectomy, Male genital diseases, Testicular diseases, Malignant tumor, Surgery, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0016893

    Code Inist : 002B20B02. Création : 21/05/1997.