| Item type |
学術雑誌論文 / Journal Article(1) |
| 公開日 |
2019-03-08 |
| タイトル |
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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 |
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言語 |
eng |
| 資源タイプ |
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資源タイプ識別子 |
http://purl.org/coar/resource_type/c_6501 |
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資源タイプ |
journal article |
| 著者 |
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 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Adv Transplant & Regenerat Med, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Adv Transplant & Regenerat Med, Grad Sch Med |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 著者所属 |
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値 |
Aomori Rosai Hosp, Dept Urol |
| 著者所属 |
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値 |
Mutsu Gen Hosp, Dept Urol |
| 著者所属 |
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値 |
Aomori Prefectural Cent Hosp, Dept Urol |
| 著者所属 |
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値 |
Hirosaki Univ, Dept Urol, Grad Sch Med |
| 抄録 |
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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. |
| 書誌情報 |
ONCOTARGET
巻 8,
号 39,
p. 65492-64505,
発行日 2017-09-12
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| ISSN |
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収録物識別子タイプ |
ISSN |
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収録物識別子 |
1949-2553 |
| DOI |
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関連タイプ |
isIdenticalTo |
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識別子タイプ |
DOI |
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関連識別子 |
10.18632/oncotarget.19043 |
| 著者版フラグ |
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出版タイプ |
VoR |
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出版タイプResource |
http://purl.org/coar/version/c_970fb48d4fbd8a85 |
| 資源タイプ |
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|
値 |
Article |
oncotarget-65492 (5.9 MB)
