Fluorescence-guided transurethral resection of bladder cancer using hexaminolevulinate: analysis of health economic impact in Sweden

被引:31
作者
Malmstrom, Per-Uno [2 ]
Hedelin, Hans [3 ]
Thomas, Yngvil Kloster [4 ]
Thompson, Gwilym J. [1 ]
Durrant, Helen [1 ]
Furniss, Jim [1 ]
机构
[1] Bridgehead Int Ltd, Melton Mowbray LE13 0PB, England
[2] Uppsala Univ, Akad Sjukhuset, Uppsala, Sweden
[3] Karnsjukhuset, Skovde, Sweden
[4] PhotoCure ASA, Oslo, Norway
来源
SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY | 2009年 / 43卷 / 03期
关键词
Bladder; bladder cancer; computer model; costs and cost analysis; cystoscopy; CARCINOMA IN-SITU; INDIVIDUAL PATIENTS; CLINICAL-TRIAL; RECURRENCE; COST; MULTICENTER; PROGRESSION; CYSTOSCOPY; TUMORS;
D O I
10.1080/00365590902808541
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Objective. A decision analytic model was established to estimate the budget impact on the Swedish health service of using hexaminolevulinate (HAL) in conjunction with white light cystoscopy (WLC) in the management of bladder cancer for 1 year following initial diagnosis. Material and methods. Flowcharts were developed to represent the diagnostic and treatment pathways for each of four risk groups for non-muscle-invasive bladder cancer (NMIBC), as defined by risk of tumour recurrence and progression. Flowcharts were based on European Association of Urology Guidelines and adjusted to current Swedish clinical practice. The model covers the use of HAL cystoscopy in the operating room to guide transurethral resection of the bladder (TURB) in all patients. HAL cystoscopy as an adjunct to WLC allows for more accurate and complete resection of tumours compared with WLC alone, and the model assumed a consequent reduction in recurrence of 40%. Results. The model projects that compared with WLC alone, use of HAL cystoscopy in the first TURB of all patients and for all TURBs due to recurrence in the first year after diagnosis, leads to a reduction of 23 cystectomies and 180 TURBs in a population of 2032 newly diagnosed bladder cancer patients. Avoidance of these procedures would result in a saving of SEK1 321 716 to the Swedish health service. Conclusion. HAL cystoscopy, used as an adjunct to white light in guiding TURB in NMIBC patients, may result in reduction of invasive, time-intensive and high-cost procedures such as cystectomy and TURB, compared with WLC alone.
引用
收藏
页码:192 / 198
页数:7
相关论文
共 15 条
[1]   Cancer incidence and mortality in Europe, 2004 [J].
Boyle, P ;
Ferlay, J .
ANNALS OF ONCOLOGY, 2005, 16 (03) :481-488
[2]   Photodynamic diagnostics and noninvasive bladder cancer: Is it cost-effective in long-term application? A Germany-based cost analysis [J].
Burger, Maximilian ;
Zaak, Dirk ;
Stief, Christian G. ;
Filbeck, Thomas ;
Wieland, Wolf-Ferdinand ;
Roessler, Wolfgang ;
Denzinger, Stefan .
EUROPEAN UROLOGY, 2007, 52 (01) :142-147
[3]   Long-term benefit of 5-aminolevulinic acid fluorescence assisted transurethral resection of superficial bladder cancer: 5-year results of a prospective randomized study [J].
Daniltchenko, DI ;
Riedl, CR ;
Sachs, MD ;
Koenig, F ;
Daha, KL ;
Pflueger, H ;
Loening, SA ;
Schnorr, D .
JOURNAL OF UROLOGY, 2005, 174 (06) :2129-2133
[4]   The effect of repeat transurethral resection on recurrence and progression rates in patients with T1 tumors of the bladder who received intravesical mitomycin:: A prospective, randomized clinical trial [J].
Divrik, RT ;
Yildirim, Ü ;
Zorlu, F ;
Özen, H .
JOURNAL OF UROLOGY, 2006, 175 (05) :1641-1644
[5]   Clinically relevant improvement of recurrence-free survival with 5-aminolevulinic acid induced fluorescence diagnosis in patients with superficial bladder tumors [J].
Filbeck, T ;
Pichlmeier, U ;
Knuechel, R ;
Wieland, WF ;
Roessler, W .
JOURNAL OF UROLOGY, 2002, 168 (01) :67-71
[6]   The cost of bladder tumour treatment and follow-up [J].
Hedelin, H ;
Holmäng, S ;
Wiman, L .
SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY, 2002, 36 (05) :344-347
[7]   A second-look TUR in T1 transitional cell carcinoma:: Why? [J].
Jakse, G ;
Algaba, F ;
Malmström, PU ;
Oosterlinck, W .
EUROPEAN UROLOGY, 2004, 45 (05) :539-546
[8]   Hexyl aminolevulinate fluorescence cystoscopy:: A new diagnostic tool for the photodiagnosis of superficial bladder cancer -: A multicenter study [J].
Jichlinski, P ;
Guillou, L ;
Karlsen, SJ ;
Malmström, PU ;
Jocham, D ;
Brennhovd, B ;
Johansson, E ;
Gärtner, T ;
Lange, N ;
van den Bergh, H ;
Leisinger, HJ .
JOURNAL OF UROLOGY, 2003, 170 (01) :226-229
[9]   Improved detection and treatment of bladder cancer using hexaminolevulinate imaging:: A prospective, phase III multicenter study [J].
Jocham, D ;
Witjes, F ;
Wagner, S ;
Zeylemaker, B ;
van Moorselaar, J ;
Grimm, MO ;
Muschter, R ;
Popken, G ;
König, F ;
Knüchel, R ;
Kurth, KH .
JOURNAL OF UROLOGY, 2005, 174 (03) :862-866
[10]   PREDICTABILITY OF RECURRENT AND PROGRESSIVE DISEASE IN INDIVIDUAL PATIENTS WITH PRIMARY SUPERFICIAL BLADDER-CANCER [J].
KIEMENEY, LALM ;
WITJES, JA ;
HEIJBROEK, RP ;
VERBEEK, ALM ;
DEBRUYNE, FMJ .
JOURNAL OF UROLOGY, 1993, 150 (01) :60-64