Evidence map›Paper›PMID 32298794›Full record

ArticlePractical radiation oncology

Costs and Complications After a Diagnosis of Prostate Cancer Treated With Time-Efficient Modalities: An Analysis of National Medicare Data.

Chad Tang, Xiudong Lei, Grace L Smith, Hubert Y Pan, Kenneth Hess, Aileen Chen, Karen E Hoffman, Brian F Chapin, Deborah A Kuban, Mitchell Anscher and 3 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Practical radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Article
  7. Influence of Geography on Prostate Cancer Treatment.International journal of radiation oncology, biology, physics · 2021
    Article
  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 1 institution in 1 country.

Chad TangDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Xiudong LeiDepartment of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Grace L SmithDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Hubert Y PanDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Kenneth HessDepartment of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Aileen ChenDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Karen E HoffmanDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Brian F ChapinDepartment of Urology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Deborah A KubanDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Mitchell AnscherDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ya-Chen Tina ShihDepartment of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Steven J FrankDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Benjamin D SmithDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: bsmith3@mdanderson.org.
The University of Texas MD Anderson Cancer Center · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
Technology Diffusion in Cancer: Geographic Variations, Facilitators, Outcomes, and CostsR01CA207216 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI SHIH, YA-CHEN TINA · 2016 to 2020
$1.6M
Economic Strain and Resilience in Cancer Patients: Assessing Patient-Reported Measures of the Burdens of TreatmentK07CA211804 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI SMITH, GRACE · 2016 to 2020
$853k
NCI NIH HHS K07 CA211804NCI NIH HHS P30 CA016672NCI NIH HHS R01 CA207216
6 · The paper itself

Abstract

purposeRecent trends in payer and patient preferences increasingly incentivize time-efficient (≤2-week treatment time) prostate cancer treatments. METHODS AND MATERIALS: National Medicare claims from January 1, 2011, through December 31, 2014, were analyzed to identify newly diagnosed prostate cancers. Three "radical treatment" cohorts were identified (prostatectomy, brachytherapy, and stereotactic body radiation therapy [SBRT]) and matched to an active surveillance (AS) cohort by using inverse probability treatment weighting via propensity score. Total costs at 1 year after biopsy were calculated for each cohort, and treatment-specific costs were estimated by subtracting total 1-year costs in each radical treatment group from those in the AS group.

resultsMean 1-year adjusted costs were highest among patients receiving SBRT ($26,895), lower for prostatectomy ($23,632), and lowest for brachytherapy ($19,980), whereas those for AS were $9687. Costs of radical modalities varied significantly by region, with the Mid-Atlantic and New England regions having the highest cost ranges (>$10,000) and the West South Central and Mountain regions the lowest range in costs (<$2000). Quantification of toxic effects showed that prostatectomy was associated with higher genitourinary incontinence (hazard ratio [HR] = 10.8 compared with AS) and sexual dysfunction (HR = 3.5), whereas the radiation modalities were associated with higher genitourinary irritation/bleeding (brachytherapy HR = 1.7; SBRT HR = 1.5) and gastrointestinal ulcer/stricture/fistula (brachytherapy HR = 2.7; SBRT HR = 3.0). Overall mean toxicity costs were highest among patients treated with prostatectomy ($3500) followed by brachytherapy ($1847), SBRT ($1327), and AS ($1303).

conclusionsTime-efficient treatment techniques exhibit substantial variability in toxicity and costs. Furthermore, geographic location substantially influenced treatment costs.

Indexed as

AgedAged, 80 and overHumansMaleMedicareProstatic NeoplasmsRisk FactorsUnited States

Identifiers

PMID32298794
PMCPMC7395481
OpenAlexW3016799310

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.