25 June 2019

In European Urology Oncology Sejal Patel and colleagues evaluated the potential cost-effectiveness of including mpMRI in active surveillance for men diagnosed with low-risk prostate cancer in comparison to the standard monitoring program comprising of biopsies.

Abstract

Background
Active surveillance (AS) has limitations that include missing high-risk tumors and performing unnecessary biopsies. The use of multiparametric magnetic resonance imaging (mpMRI) in AS may overcome these limitations, but its cost-effectiveness remains uncertain.
Objective
To determine the cost-effectiveness of three AS strategies: AS with transrectal ultrasound-guided biopsy (TRUSGB), AS with mpMRI and MRI ultrasound-guided biopsy (MR-TRUSGB), and AS with mpMRI without biopsies.
Design, setting and participants
A Markov cohort model for men with low-risk prostate cancer was developed to assess the three strategies. Input data were derived from meta-analysis, other published literature, and national cost reports. A health care perspective was used for a European setting.
Outcome measurements and statistical analysis
Health care costs and quality-adjusted life years (QALYs) were modeled over a lifetime horizon. Deterministic and probabilistic sensitivity analyses were performed to address uncertainty in model parameters.
Results and limitations
In the base case analysis, expected mean costs per man screened were €5150 for TRUSGB, €5994 for mpMRI without biopsy, and €4848 for mpMRI with biopsy. Corresponding QALYs were higher for mpMRI with biopsy compared to TRUSGB (18.67 vs 18.66) and lower for mpMRI without biopsy compared to TRUSGB (18.27 vs 18.66). Owing to lower costs and higher effects, the mpMRI with biopsy strategy was cost-effective compared to the TRUSGB strategy.
Conclusions
mpMRI with MR-TRUSGB appears to be the most cost-effective AS strategy for men with low-risk prostate cancer.
Patient summary
We compared costs and quality of life for the standard active surveillance (AS) program for men diagnosed with low-risk prostate cancer to a monitoring program comprising multiparametric magnetic resonance imaging (mpMRI) with and without biopsies. Our results suggest that an AS strategy using mpMRI with biopsy improves quality of life and costs decrease. An AS strategy using mpMRI without biopsy was not beneficial compared to the standard program.
 

Publication
The Role of Multiparametric Magnetic Resonance Imaging in Active Surveillance for Men with Low-risk Prostate Cancer: A Cost-effectiveness Modeling Study
Patel S, Rongen JJ, Fütterer JJ, Boltyenkov A, Rovers MM.

Sejal Patel is member of theme Urological cancers.

Related news items


Bas Loomans received Mid-Career Award

18 July 2019

Bas Loomans received in Vancouver the STEPHEN BAYNE MID-CAREER AWARD of the International Association for Dental Research (IADR)

read more

4,8 million euros for prevention of tuberculosis among people with diabetes in Africa

16 July 2019

Reinout van Crevel and Lindsey te Brake have received European funding of 4.8 million euros to lead an international consortium to screen thousands of people with diabetes in Uganda and Tanzania for TB, and investigate the effect and costs of 3 months preventive treatment for TB.

read more

50.000 grant for Paul de Jonge and Harry Dolstra

15 July 2019

Paul de Jonge and Harry Dolstra, theme Cancer development and immune defense, received a €50.000,- (NWA-IDG) grant for their project regarding cancer immunotherapy.

read more

Handbook of biomarkers and precision medicine a new publication by Alain van Gool

12 July 2019

Alain van Gool published a new handbook on biomarkers and applications in (pre)clinical drug development for precision medicine.

read more

The real impact of menstrual complaints on work and school productivity

8 July 2019

Menstrual period symptoms may be linked to nearly nine days of lost productivity every year, through presenteeism, suggests the largest study of its kind, published in the journal BMJ Open. But the real impact on women and society is underestimated and poorly appreciated, say the researchers.

read more

Walking for science Research by Radboud university medical center and Radboud University during the Vierdaagse (Four Day Marches)

5 July 2019

The Vierdaagse is a unique opportunity to conduct research into physical activity and healthy lifestyle.

read more