Protocol for a systematic review and economic modelling of the relative clinical benefit and cost-effectiveness of laparoscopic surgery and robotic surgery for removal of the prostate in men with localised prostate cancer

摘要

Description of the underlying health problem The decision about which treatment is best for a man diagnosed with cancer of the prostate, a sex gland located at the base of the bladder in the pelvis, presents an abundance of different but interrelated aspects that have been the focus of a number of previous Health Technology Assessments (HTAs) worldwide.1"3 The present review was tasked with determining whether, for the UK NHS, complete removal of the prostate (radical prostatectomy) is best achieved using laparoscopic (keyhole) surgery or robotic surgery. To understand the need for the review it is first necessary to consider changes in the characteristics of men diagnosed with prostate cancer over the last 30 years (see Evolution of prostate cancer diagnosis) and the resultant evolution of the technique of radical prostatectomy during that time period (see Development of radical prostatectomy). The technologies to be considered will then be described (see Description of the interventions) followed by an outline of the current demand for their use in the NHS (see Current use in the UK NHS).