IBCN 2020: Comparing Costs of Radical Versus Partial Cystectomy for Patients Diagnosed with Localized Muscle-Invasive Bladder Cancer: Understanding the Value of Surgical Care

(UroToday.com) Dr. Stephen Williams, Urologist from the University of Texas Medical Branch, Galveston, Texas, USA presented “Comparing Costs of Radical Versus Partial Cystectomy for Patients Diagnosed with Localized muscle-invasive bladder cancer (MIBC): Understanding the Value of Surgical Care.”  The authors interrogated the SEER-Medicare database to identify 2,035 patients with cT2-4 bladder cancer treated with partial vs. radical cystectomy. 

At 90, 180, 365 days there was no significant difference in median total costs between the two procedures.  Patients who underwent partial cystectomy had similar overall survival but worse cancer-specific survival compared to radical cystectomy (HR for CSS 1.45 [1.34-1.58], p<0.001).  With improved oncologic outcomes in radical cystectomy and similar costs, these data support RC as a higher-value surgical procedure for MIBC compared to partial cystectomy.  It would be interesting to evaluate the cost of these data with regards to operative modality, including open vs. robotic techniques.

Dr. Stephen Williams, Urologist from the University of Texas Medical Branch in Galveston, also presented “Use of Psychotropic Drugs Among Bladder Cancer Patients in the US.”  Over 50% of bladder cancer patients have a new psychiatric diagnosis following bladder cancer treatment.  The authors utilized the SEER-Medicare database to assess psychotropic prescription patterns in bladder cancer patients.  In over 10,000 patients, 53% were prescribed psychotropic drugs following a cancer diagnosis.  Notably, prescription rates were higher among patients with higher stage disease.  Interestingly, adherence to medications was low and decreased with time after a bladder cancer diagnosis.  It would be interesting to study psychiatric diagnoses in relation to modalities of bladder cancer treatment, as side effects related to caustic intravesical therapies as well as cystectomy with urinary diversion can have significant and different psychosocial and sexual impacts.

Presented by: Stephen B. Williams, MD, MS, FACS, Chief, Division of Urology, Professor of Urology and Radiology (Tenured), Robert Earl Cone Professorship, Director of Urologic Oncology, Director of Urologic Research, Co-Director Department of Surgery Clinical Outcomes Research Program, Medical Director for High-Value Care, UTMB Health System, Galveston, Texas

Written by: Dr. Patrick Hensley, Urologic Oncology Fellow at MD Anderson Cancer Center, Twitter: @pjhensley11, with Ashish Kamat, MD, MBBS, President of The International Bladder Cancer Network (IBCN), The International Bladder Cancer Group (IBCG), and Professor of the Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas, Twitter: @UroDocAsh, at the International Bladder Cancer Network (IBCN) Annual Meeting, #IBCN2020, October 17, 2020.

Related Content:
Comparative Analyses of Costs and Survival Between Radical Cystectomy and Trimodal Therapy - Stephen Williams
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