Latest Comprehensive Medical Resource Consumption in Robot-Assisted versus Laparoscopic and Traditional Open Radical Prostatectomy: A Nationwide Population-Based Cohort Study
Abstract
:Simple Summary
Abstract
1. Introduction
2. Patients and Methods
2.1. Data Source
2.2. Study Cohort
2.3. Covariates and Endpoints
2.4. Statistical Analysis
3. Results
3.1. Clinicopathological Characteristics
3.2. Number of Urology Outpatient Clinic Visit Stratified by RP Method
3.3. Hospitalization for Urinary Diseases or Surgical Complications Stratified by RP Method
3.4. Medical Reimbursement for Urinary Diseases or Surgical Complications Stratified by RP Method
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
RP | Radical prostatectomy |
PC | Prostate cancer |
T | Tumor |
PSA | Prostate-specific antigen |
ORP | Open radical prostatectomy |
LRP | Laparoscopic radical prostatectomy |
RARP | Robot-assisted radical prostatectomy |
TCRD | Taiwan Cancer Registry database |
NHI | National Health Insurance |
NHIRD | National Health Insurance Research Data |
NTD | New Taiwan Dollars |
MIRP | Minimally invasive radical prostatectomy |
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Characteristics | Open RP N = 315 | Laparoscopic RP N = 276 | Robotic RP N = 816 | p Value | ||||
---|---|---|---|---|---|---|---|---|
n | (%) | n | (%) | n | (%) | |||
Age (years) | Mean (SD) | 66.4 | (6.8) | 66.8 | (6.4) | 66.1 | (6.7) | 0.4661 |
Median (IQR) | 67 | (62–71) | 67 | (62–72) | 66 | (62–71) | ||
20–59 | 49 | (15.6) | 41 | (14.9) | 130 | (15.9) | 0.9004 | |
60–69 | 165 | (52.4) | 146 | (52.9) | 444 | (54.4) | ||
70+ | 101 | (32.1) | 89 | (32.2) | 242 | (29.7) | ||
Clinical T-stage | cT1 | 84 | (26.7) | 75 | (27.2) | 195 | (23.9) | 0.2839 |
cT2 | 149 | (47.3) | 133 | (48.2) | 436 | (53.4) | ||
cT3-cT4 | 82 | (26.0) | 68 | (24.6) | 185 | (22.7) | ||
Pathological T-stage | pT1 | 96 | (30.5) | 83 | (30.1) | 237 | (29.0) | 0.1884 |
pT2 | 152 | (48.3) | 137 | (49.6) | 432 | (52.9) | ||
pT3a | 37 | (11.7) | 30 | (10.9) | 76 | (9.3) | ||
pT3b | 30 | (9.5) | 26 | (9.4) | 71 | (8.7) | ||
Gleason score | 2–6 | 34 | (10.8) | 37 | (13.4) | 142 | (17.4) | 0.0951 |
3+4 | 110 | (34.9) | 89 | (32.2) | 274 | (33.6) | ||
4+3 | 62 | (19.7) | 53 | (19.2) | 160 | (19.6) | ||
8–10 | 109 | (34.6) | 97 | (35.1) | 240 | (29.4) | ||
Preoperative PSA (ng/mL) | Mean (SD) | 15.8 | (15.9) | 17.6 | (17.8) | 15.8 | (16.6) | 0.3483 |
Median (IQR) | 10.3 | (6.9–18.0) | 10.4 | (7.0–20.5) | 10.3 | (6.7–17.6) | ||
Preoperative PSA (ng/mL) | 0–5 | 37 | (11.7) | 32 | (11.6) | 94 | (11.5) | 0.6540 |
6–10 | 110 | (34.9) | 95 | (34.4) | 285 | (34.9) | ||
11–20 | 86 | (27.3) | 82 | (29.7) | 233 | (28.6) | ||
20+ | 82 | (26.0) | 67 | (24.3) | 204 | (25.0) | ||
D’Amico risk classification | Low | 13 | (4.1) | 15 | (5.4) | 58 | (7.1) | 0.1117 |
Intermediate | 93 | (29.5) | 69 | (25.0) | 219 | (26.8) | ||
High | 122 | (38.7) | 120 | (43.5) | 338 | (41.4) | ||
Advanced | 87 | (27.6) | 72 | (26.1) | 201 | (24.6) | ||
Hospital level | Academic center | 258 | (81.9) | 225 | (81.5) | 673 | (82.5) | 0.7251 |
Nonacademic center | 57 | (18.1) | 51 | (18.5) | 143 | (17.5) | ||
Follow-up duration (months) | Mean (SD) | 36.1 | (4.4) | 37.2 | (5.0) | 36.2 | (4.7) | |
Death | 8 | (2.5) | 4 | (1.4) | 11 | (1.3) | 0.3534 |
Numbers of Outpatient Clinic Visits | Open RP N = 315 | Laparoscopic RP N = 276 | Robotic RP N = 816 | p Value * | ||||
---|---|---|---|---|---|---|---|---|
First year after RP | Mean (SD) | 33.0 | (10.5) | 32.0 | (11.6) | 36.0 | (11.8) | 0.72114 |
Median (IQR, Q1–Q3) | 23 | (17–30) | 23 | (17–30) | 22 | (16–31) | ||
Second year after RP | Mean (SD) | 22.8 | (12.7) | 23.3 | (13.0) | 22.1 | (13.1) | 0.9478 |
Median (IQR, Q1–Q3) | 21 | (14–29) | 20 | (14–30) | 19 | (13–28) | ||
Third year after RP | Mean (SD) | 16.9 | (11.7) | 13.1 | (12.7) | 10.3 | (10.6) | <0.0001 |
Median (IQR, Q1–Q3) | 15 | (7–22) | 10 | (6–19) | 7 | (5–15) |
Hospitalization (%) | Open RP N = 315 | Laparoscopic RP N = 276 | Robotic RP N = 816 | p Value * | |||
---|---|---|---|---|---|---|---|
First year after RP | 127 | (40.3) | 113 | (40.9) | 319 | (39.0) | 0.8799 |
Second year after RP | 81 | (25.7) | 61 | (22.1) | 187 | (22.9) | 0.6151 |
Third year after RP | 59 | (18.7) | 27 | (9.8) | 89 | (10.9) | 0.0014 |
Medical Cost (NTD) | Open RP N = 315 | Laparoscopic RP N = 276 | Robotic RP N = 816 | p Value * | ||||
---|---|---|---|---|---|---|---|---|
First year after RP | Mean (SD) | 230492.4 | (140659.6) | 232261.9 | (141475.8) | 181923.1 | (125129.5) | 0.0052 |
Median (IQR, Q1–Q3) | 178584 | (145267–245037) | 177489 | (147614–237280) | 142619 | (110697–193688) | ||
Second year after RP | Mean (SD) | 114771.2 | (199274.4) | 95077.7 | (144789.0) | 88050.5 | (140079.7) | 0.1280 |
Median (IQR, Q1–Q3) | 53493 | (22457–109758) | 43428 | (23227–93992) | 45653 | (21740–84986) | ||
Third year after RP | Mean (SD) | 75767.3 | (138665.8) | 57092.6 | (119648.4) | 45426.1 | (97456.8) | 0.0024 |
Median (IQR, Q1–Q3) | 32246 | (10844–71234) | 20456 | (5192–46936) | 14509 | (4320–39596) | ||
3-year total | Mean (SD) | 421030 | (153387.1) | 384432 | (13326.2) | 315399 | (116010.3) | 0.0029 |
Median (IQR, Q1–Q3) | 264323 | (14223–131167) | 241373 | (14427–126241) | 202781 | (56610–109821) |
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Wu, S.-Y.; Chang, S.-C.; Chen, C.-I.; Huang, C.-C. Latest Comprehensive Medical Resource Consumption in Robot-Assisted versus Laparoscopic and Traditional Open Radical Prostatectomy: A Nationwide Population-Based Cohort Study. Cancers 2021, 13, 1564. https://doi.org/10.3390/cancers13071564
Wu S-Y, Chang S-C, Chen C-I, Huang C-C. Latest Comprehensive Medical Resource Consumption in Robot-Assisted versus Laparoscopic and Traditional Open Radical Prostatectomy: A Nationwide Population-Based Cohort Study. Cancers. 2021; 13(7):1564. https://doi.org/10.3390/cancers13071564
Chicago/Turabian StyleWu, Szu-Yuan, Shyh-Chyi Chang, Chang-I Chen, and Chung-Chien Huang. 2021. "Latest Comprehensive Medical Resource Consumption in Robot-Assisted versus Laparoscopic and Traditional Open Radical Prostatectomy: A Nationwide Population-Based Cohort Study" Cancers 13, no. 7: 1564. https://doi.org/10.3390/cancers13071564