Modeling costs for prostate surgery: Are we close to reality?

摘要

There is a demand for analysis of the cost effectiveness of new surgical technologies. The total societal costs of prostate cancer (PCa) surgery have increased markedly due to the rising incidence of men contracting PCa combined with the implementation of new surgical techniques. Robot-assisted laparoscopic radical prostatectomy (RARP) has been introduced as a new approach in patients with localized PCa. The procedural costs for RARP are probably higher than for open retropubic radical prostatectomy (ORP) and possibly also for laparoscopic radical prostatectomy (LRP). The reasons behind the rapid implementation of RARP are probably multifactorial (eg, intense marketing to surgeons, hospitals, and patients), but without large-scale controlled trials in support of the new technique, this development is still surprising. Certain advantages have been suggested for RARP compared with LRP, such as a shorter learning curve, three-dimensional vision, and better ergonometry, but we do not know if these advantages translate to patient benefits. Moreover, the disadvantages, including no haptic feedback, may shadow advantages. Consequently, the need to study cost effectiveness is urgent.