Surveillance Is Not a Viable and Appropriate Treatment Option in the Management of Localized Prostate Cancer

Hugosson, Jonas; Aus, Gunnar; Norlén, Lars

doi:10.1016/s0094-0143(05)70336-0

Cited by 17 publications

(14 citation statements)

References 46 publications

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“…Additionally, Hugosson et al, reported that men who died of prostate cancer had more than 50% higher costs compared with men with prostate cancer who died of other causes. 7 Information regarding medication usage, especially outpatient use, ie pain or hormonal ablation, admittedly was incomplete in this study. Because of this, some assumptions had to be made but were always done so in an underestimation.…”

Section: Discussionmentioning

confidence: 96%

“…Even for those patients in their sixties with moderately differentiated tumors (Gleason's score 5, 6, 7) the risk of ultimately dying of localized disease that was initially observed is over 60%. 7 The majority of men with metastatic disease will die and will require intensive palliation during their terminal year. Until the natural history of localized disease for the individual patient can be predicted it must be assumed that his disease is potentially lethal in the absence of a significant competing co-morbidity.…”

Section: Discussionmentioning

confidence: 99%

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Adenocarcinoma of the prostate: an expensive way to die

Piper

Kusada

Lance

et al. 2002

Prostate Cancer Prostatic Dis

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The costs of radical prostatectomy and radiation therapy for localized carcinoma of the prostate are well known, the costs of terminal care for men with metastatic disease less so. We sought to determine the costs of terminal care incurred with prostate cancer in the last year of life. A retrospective chart review was conducted at five military medical centers identifying 32 patients who had died from prostate cancer from 1995 to 1997. The data investigated were: duration of metastatic disease, days hospitalized in the last year of life, palliative procedures (surgery or radiation), chemotherapy and need for transfusions. The mean duration of symptomatic metastatic disease was 3.4 y. The mean duration of hospitalization in the last year of life was 19 days. Seven patients (22%) required channel transurethral resection of the prostate (TURP). Three patients (9%) required either percutaneous nephrostomies or stenting. The mean number of transfusions required was 5.4. Eighteen patients (56%) underwent bilateral simple orchiectomy (BSO), 14 (44%) used LHRH agonists and 11 (34%) used antiandrogens. The mean total cost of hospitalization, studies, outpatient visits to physicians, palliative procedures and hormonal therapy was $24 660 in the last year of life. Comparatively, the cost of radical prostatectomy is $12 250 and threedimensional conformal radiation therapy is $13 823. Our estimation of costs due to metastatic disease is at best an underestimation. Men dying of prostate cancer incur significant costs in the last year of life. Based upon recent epidemiological data the cost of death due to prostate cancer in the US is over three quarters of a billion dollars a year.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Adenocarcinoma of the prostate: an expensive way to die

Piper

Kusada

Lance

et al. 2002

Prostate Cancer Prostatic Dis

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“…Based on this, they argue that all patients need immediate aggressive local therapy. 23 Their study design has been severely criticised, however, 24,25 and simulations with both this and conventional study design have shown that they probably overestimated the mortality from prostate cancer with a long follow-up. 16,26 A previously unrecognized bias in the study design of the Gothenburg series results from the fact that the follow-up time becomes directly related to the year when the patients were diagnosed.…”

Section: Discussionmentioning

confidence: 99%

Localized prostate cancer and 30 years of follow-up in a population-based setting

Adolfsson

Oksanen

Saló

et al. 2000

Prostate Cancer Prostatic Dis

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“…9 Based on this the authors later argue that all patients needs immediate aggressive local therapy. 34 In their study Aus et al 9 de®ned the study population as those who died with the diagnosis of prostate cancer irrespective of the cause of death during 1988± 1990. The de®ned follow-up time was from diagnosis to time of death.…”

Section: Commentsmentioning

confidence: 99%

Conservative management of clinically localized prostate cancer

Adolfsson

1997

Prostate Cancer Prostatic Dis

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The purpose of this paper is to review and summarize the current knowledge on conservative management of localized prostate cancer. Deferring treatment for low-grade, clinically localized prostate cancer is an acceptable treatment option for patients with a life expectancy of 10±15 y or less. The outcome of available studies on deferred treatment in selected series cannot be compared with the outcome in register studies where the patients have been managed with noncurative intent, nor can it be directly compared with the outcome of selected series on other treatments. The outcome of different treatments for localized prostate cancer can only be compared in randomized studies.

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Surveillance Is Not a Viable and Appropriate Treatment Option in the Management of Localized Prostate Cancer

Cited by 17 publications

References 46 publications

Adenocarcinoma of the prostate: an expensive way to die

Adenocarcinoma of the prostate: an expensive way to die

Localized prostate cancer and 30 years of follow-up in a population-based setting

Conservative management of clinically localized prostate cancer

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