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    Cost considerations in the management of bladder cancer

    Areas of improvement can help cut high expenditures associated with care, improve outcomes



    1. Riley GF, Potosky AL, Lubitz JD, et al. Medicare payments from diagnosis to death for elderly cancer patients by stage at diagnosis. Med Care 1995; 33:828-41.
    2. Mariotto AB, Yabroff KR, Shao Y, Feet al. Projections of the cost of cancer care in the United States: 2010-2020. J Natl Cancer Inst 2011; 103:117-28.
    3. Skolarus TA, Ye Z, Montgomery JS, et al. Use of restaging bladder tumor resection for bladder cancer among Medicare beneficiaries. Urology 2011; 78:1345-9.
    4. Hollenbeck BK, Ye Z, Dunn RL, et al. Provider treatment intensity and outcomes for patients with early-stage bladder cancer. J Natl Cancer Inst 2009; 101:571-80.
    5. Karl A, Adejoro O, Saigal C, et al. General adherence to guideline recommendations on initial diagnosis of bladder cancer in the United States and influencing factors. Clin Genitourin Cancer 2014; 12:270-7.
    6. O'Neil B, Graves AJ, Barocas DA, et al. Doing More for More: Unintended Consequences of Financial Incentives for Oncology Specialty Care. J Natl Cancer Inst 2016; 108.
    7. Messing EM, Madeb R, Young T, et al. Long-term outcome of hematuria home screening for bladder cancer in men. Cancer 2006; 107:2173-9.
    8. Messing EM, Young TB, Hunt VB, et al. Hematuria home screening: repeat testing results. J Urol 1995; 154:57-61.
    9. Ellwein LB, Farrow GM, Friedell GH, et al. An assessment of the impact of urine cytology screening using a computer-based model of bladder cancer. Urol Clin North Am 1984; 11:585-98.
    10. Svatek RS, Sagalowsky AI, Lotan Y. Economic impact of screening for bladder cancer using bladder tumor markers: a decision analysis. Urol Oncol 2006; 24:338-43.
    11. Lotan Y, Svatek RS, Sagalowsky AI. Should we screen for bladder cancer in a high-risk population?: A cost per life-year saved analysis. Cancer 2006; 107:982-90.
    12. Thériault GP, Tremblay CG, Armstrong BG. Bladder cancer screening among primary aluminum production workers in Quebec. J Occup Med 1990; 32:869-72.
    13. Friedman GD, Hiatt RA, Quesenberry CP. Problems in assessing screening experience in observational studies of screening efficacy: example of urinalysis screening for bladder cancer. J Med Screen 1995; 2:219-23.
    14. Lotan Y, Elias K, Svatek RS, et al. Bladder cancer screening in a high risk asymptomatic population using a point of care urine based protein tumor marker. J Urol 2009; 182:52-7; discussion 8.
    15. Chou R, Dana T. Screening adults for bladder cancer: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2010; 153:461-8.
    16. Chang SS, Boorjian SA, Chou R, et al. Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline. J Urol 2016; 196:1021-9.
    17. Pruthi RS, Baldwin N, Bhalani V, et al. Conservative management of low risk superficial bladder tumors. J Urol 2008; 179:87-90; discussion
    18. Tiu A, Jenkins LC, Soloway MS. Active surveillance for low-risk bladder cancer. Urol Oncol 2014; 32:33.e7-10.
    19. Soloway MS, Bruck DS, Kim SS. Expectant management of small, recurrent, noninvasive papillary bladder tumors. J Urol 2003; 170:438-41.
    20. Davis R, Jones JS, Barocas DA, et al. Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol 2012; 188:2473-81.
    21. Halpern JA, Chughtai B, Ghomrawi H. Cost-effectiveness of Common Diagnostic Approaches for Evaluation of Asymptomatic Microscopic Hematuria. JAMA Intern Med 2017; 177:800-7.
    22. Sylvester RJ, Oosterlinck W, van der Meijden AP. A single immediate postoperative instillation of chemotherapy decreases the risk of recurrence in patients with stage Ta T1 bladder cancer: a meta-analysis of published results of randomized clinical trials. J Urol 2004; 171:2186-90, quiz 435.
    23. Chamie K, Saigal CS, Lai J, et al. Quality of care in patients with bladder cancer: a case report? Cancer 2012; 118:1412-21.
    24. Chamie K, Saigal CS, Lai J, et al. Compliance with guidelines for patients with bladder cancer: variation in the delivery of care. Cancer 2011; :5392-401.
    25. Lamm DL, Blumenstein BA, Crissman JD, et al. Maintenance bacillus Calmette-Guerin immunotherapy for recurrent TA, T1 and carcinoma in situ transitional cell carcinoma of the bladder: a randomized Southwest Oncology Group Study. J Urol 2000; 163:1124-9.
    26. Huang GJ, Hamilton AS, Lo M, et al. Predictors of intravesical therapy for nonmuscle invasive bladder cancer: results from the Surveillance, Epidemiology and End Results program 2003 patterns of care project. J Urol 2008; 180:520-4; discussion 4.
    27. Herr HW. Role of re-resection in non-muscle-invasive bladder cancer. ScientificWorldJournal 2011; 11:283-8.
    28. Gore JL, Lai J, Setodji CM, et al. Mortality increases when radical cystectomy is delayed more than 12 weeks: results from a Surveillance, Epidemiology, and End Results-Medicare analysis. Cancer 2009; 115:988-96.
    29. Burger M, Grossman HB, Droller M, et al. Photodynamic diagnosis of non-muscle-invasive bladder cancer with hexaminolevulinate cystoscopy: a meta-analysis of detection and recurrence based on raw data. Eur Urol 2013; 64:846-54.
    30. Burger M, Zaak D, Stief CG, et al. Photodynamic diagnostics and noninvasive bladder cancer: is it cost-effective in long-term application? A Germany-based cost analysis. Eur Urol 2007; 52:142-7.
    31. Otto W, Burger M, Fritsche HM, et al. Photodynamic diagnosis for superficial bladder cancer: do all risk-groups profit equally from oncological and economic long-term results? Clin Med Oncol 2009; 3:53-8.
    32. Garfield SS, Gavaghan MB, Armstrong SO, et al. The cost-effectiveness of blue light cystoscopy in bladder cancer detection: United States projections based on clinical data showing 4.5 years of follow up after a single hexaminolevulinate hydrochloride instillation. Can J Urol 2013; 20:6682-9.
    33. Malmström PU, Hedelin H, Thomas YK, et al. Fluorescence-guided transurethral resection of bladder cancer using hexaminolevulinate: analysis of health economic impact in Sweden. Scand J Urol Nephrol 2009; 43:192-8.
    34. Svatek RS, Hollenbeck BK, Holmäng S, et al. The economics of bladder cancer: costs and considerations of caring for this disease. Eur Urol 2014; 66:253-62.
    35. Schrag D, Mitra N, Xu F, et al. Cystectomy for muscle-invasive bladder cancer: patterns and outcomes of care in the Medicare population. Urology 2005; 65:1118-25.
    36. Gray PJ, Fedewa SA, Shipley WU, et al. Use of potentially curative therapies for muscle-invasive bladder cancer in the United States: results from the National Cancer Data Base. Eur Urol 2013; 63:823-9.
    37. Gore JL, Litwin MS, Lai J, et al. Use of radical cystectomy for patients with invasive bladder cancer. J Natl Cancer Inst 2010; 102:802-11.
    38. Fedeli U, Fedewa SA, Ward EM. Treatment of muscle invasive bladder cancer: evidence from the National Cancer Database, 2003 to 2007. J Urol 2011; 185:72-8.
    39. Nix J, Smith A, Kurpad R, et al. Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results. Eur Urol 2010; 57:196-201.
    40. Bochner BH, Sjoberg DD, Laudone VP, Group MSKCCBCST. A randomized trial of robot-assisted laparoscopic radical cystectomy. N Engl J Med 2014; 371:389-90.
    41. Parekh DJ, Messer J, Fitzgerald J, et al. Perioperative outcomes and oncologic efficacy from a pilot prospective randomized clinical trial of open versus robotic assisted radical cystectomy. J Urol 2013; 189:474-9.
    42. Li K, Lin T, Fan X, et al. Systematic review and meta-analysis of comparative studies reporting early outcomes after robot-assisted radical cystectomy versus open radical cystectomy. Cancer Treat Rev 2013; 39:551-60.
    43. Tang K, Xia D, Li H, et al. Robotic vs. open radical cystectomy in bladder cancer: A systematic review and meta-analysis. Eur J Surg Oncol 2014; 40:1399-411.
    44. Ishii H, Rai BP, Stolzenburg JU, et al. Robotic or open radical cystectomy, which is safer? A systematic review and meta-analysis of comparative studies. J Endourol 2014; 28:1215-23.
    45. Smith A, Kurpad R, Lal A, et al. Cost analysis of robotic versus open radical cystectomy for bladder cancer. J Urol 2010; 183:505-9.
    46. Martin AD, Nunez RN, Castle EP. Robot-assisted radical cystectomy versus open radical cystectomy: a complete cost analysis. Urology 2011; 77:621-5.
    47. Lee R, Chughtai B, Herman M, et al. Cost-analysis comparison of robot-assisted laparoscopic radical cystectomy (RC) vs open RC. BJU Int 2011; 108:976-83.
    48. Yu HY, Hevelone ND, Lipsitz SR, et al. Comparative analysis of outcomes and costs following open radical cystectomy versus robot-assisted laparoscopic radical cystectomy: results from the US Nationwide Inpatient Sample. Eur Urol 2012; 61:1239-44.
    49. Leow JJ, Reese SW, Jiang W, et al. Propensity-matched comparison of morbidity and costs of open and robot-assisted radical cystectomies: a contemporary population-based analysis in the United States. Eur Urol 2014; 66:569-76.
    50. Tyson MD, Chang SS. Enhanced Recovery Pathways Versus Standard Care After Cystectomy: A Meta-analysis of the Effect on Perioperative Outcomes. Eur Urol 2016; 70:995-1003.
    51. Nabhani J, Ahmadi H, Schuckman AK, et al. Cost Analysis of the Enhanced Recovery After Surgery Protocol in Patients Undergoing Radical Cystectomy for Bladder Cancer. Eur Urol Focus 2016; 2:92-6.
    52. Lee CT, Chang SS, Kamat AM, et al. Alvimopan accelerates gastrointestinal recovery after radical cystectomy: a multicenter randomized placebo-controlled trial. Eur Urol 2014; 66:265-72.
    53. Kraft M, Maclaren R, Du W, et al. Alvimopan (entereg) for the management of postoperative ileus in patients undergoing bowel resection. P T 2010; 35:44-9.
    54. Kauf TL, Svatek RS, Amiel G, et al. Alvimopan, a peripherally acting μ-opioid receptor antagonist, is associated with reduced costs after radical cystectomy: economic analysis of a phase 4 randomized, controlled trial. J Urol 2014; 191:1721-7.

    Next: New payment models emphasize outcomes, value

    Sam S. Chang, MD
    Dr. Chang is Assistant Professor, Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, Tenn. He has received ...


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