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Cost-analysis of staging methods for lymph nodes in patients with prostate cancer: MRI with a lymph node-specific contrast agent compared to pelvic lymph node dissection or CT

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Abstract

The aim of this study was to compare the costs of three strategies in patients with prostate cancer in a specific setting: firstly, a strategy including MR lymphography (MRL) in which pelvic lymph node dissection (PLND) is foregone in case of a negative result. The second strategy involves computed tomography (CT) followed by a biopsy or PLND. The third strategy consists of PLND without imaging beforehand. A decision analytic model was constructed. This model represented the diagnostic process for patients with prostate cancer and intermediate or high risk for nodal metastases, comparing the costs of the three strategies. Cost analysis was done from the health care perspective. The model indicated that the expected costs for the MRL strategy were €2,527. The expected costs for the strategy using CT were €3,837 and for PLND €3,994. These results show that potential savings performing MRL instead of CT were €1,310 and €1,467 for PLND. Sensitivity analyses show that variation in costs of PLND was most influential on the costs of all strategies. However, the overall savings pattern did not alter. Average costs of MRL staging in our institution are less than for CT and PLND in staging lymph nodes of patients with prostate cancer and who are intermediate or high risk for nodal metastases.

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Authors and Affiliations

  1. Department of Medical Technology Assessment, University Medical Centre Nijmegen, P.O. Box 9101, 6500 HB, Nijmegen, The Netherlands

    Anke M. Hövels & Eddy M. Adang

  2. Department of Radiology, University Medical Centre Nijmegen, Nijmegen, The Netherlands

    Roel A. M. Heesakkers, Gerrit J. Jager & Jelle O. Barentsz

Authors
  1. Anke M. Hövels
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  2. Roel A. M. Heesakkers
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  3. Eddy M. Adang
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  4. Gerrit J. Jager
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  5. Jelle O. Barentsz
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Correspondence to Anke M. Hövels.

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Hövels, A.M., Heesakkers, R.A.M., Adang, E.M. et al. Cost-analysis of staging methods for lymph nodes in patients with prostate cancer: MRI with a lymph node-specific contrast agent compared to pelvic lymph node dissection or CT. Eur Radiol 14, 1707–1712 (2004). https://doi.org/10.1007/s00330-004-2374-5

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  • DOI: https://doi.org/10.1007/s00330-004-2374-5

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