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Risk-stratified surveillance and cost effectiveness of follow-up after radical cystectomy in patients with muscle-invasive bladder cancer
http://hdl.handle.net/10129/00006548
http://hdl.handle.net/10129/00006548e667ee4f-3f28-4562-ba85-c91a8589e9a4
名前 / ファイル | ライセンス | アクション |
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oncotarget-65492 (5.9 MB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2019-03-08 | |||||
タイトル | ||||||
タイトル | Risk-stratified surveillance and cost effectiveness of follow-up after radical cystectomy in patients with muscle-invasive bladder cancer | |||||
言語 | ||||||
言語 | eng | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Kusaka, Ayumu
× Kusaka, Ayumu× Hatakeyama, Shingo× Hosogoe, Shogo× Hamano, Itsuto× Iwamura, Hiromichi× Fujita, Naoki× Fukushi, Ken× Narita, Takuma× Hagiwara, kazuhisa× Yamamoto, Hayato× Tobisawa, Yuki× Yoneyama, Tohru× Yoneyama, Takahiro× Hashimoto, Yasuhiro× Koie, Takuya× Ito, Hiroyuki× Yoshikawa, Kazuaki× Kawaguchi, Toshiaki× Ohyama, Chikara |
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著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Adv Transplant & Regenerat Med, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Adv Transplant & Regenerat Med, Grad Sch Med | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
著者所属 | ||||||
Aomori Rosai Hosp, Dept Urol | ||||||
著者所属 | ||||||
Mutsu Gen Hosp, Dept Urol | ||||||
著者所属 | ||||||
Aomori Prefectural Cent Hosp, Dept Urol | ||||||
著者所属 | ||||||
Hirosaki Univ, Dept Urol, Grad Sch Med | ||||||
抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | Background: The recurrence risk stratification and the cost effectiveness of oncological surveillance after radical cystectomy are not clear. We aimed to develop a risk stratification and a surveillance protocol with improved cost effectiveness after radical cystectomy. Results: Of 581 enrolled patients, 175 experienced disease recurrences. The pathology-based protocol presented significant differences in recurrence-free survival between normal-and high-risk patients, but the medical expense was high, especially in normal-risk (<= pT2pN0) patients. Cox regression analysis identified six factors associated with recurrence-free survival. Risk score-based 5-year follow-up was significantly more cost effective than the pathology-based protocol. Materials and Methods: We retrospectively evaluated 581 patients with radical cystectomy for muscle-invasive bladder cancer at 4 hospitals. Patients with routine oncological follow-up were stratified into normal-and high-risk groups by a pathology-based protocol utilizing pT, pN, lymphovascular invasion, and histology. Cost effectiveness of the pathology-based protocol was evaluated and a risk-score-based protocol was developed to optimize cost effectiveness. Risk-scores were calculated by summing risk factors independently associated with recurrence-free survival. Patients were stratified by low-, intermediate-, and high-risk score. Estimated cost per one recurrence detection by the pathology and by risk-scores were compared. Conclusions: Risk-score-stratified surveillance protocol has potential to reduce over-evaluation after radical cystectomy without adverse effects on medical cost. |
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書誌情報 |
ONCOTARGET 巻 8, 号 39, p. 65492-64505, 発行日 2017-09-12 |
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ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 1949-2553 | |||||
DOI | ||||||
関連タイプ | isIdenticalTo | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.18632/oncotarget.19043 | |||||
著者版フラグ | ||||||
出版タイプ | VoR | |||||
出版タイプResource | http://purl.org/coar/version/c_970fb48d4fbd8a85 | |||||
資源タイプ | ||||||
値 | Article |