Risk score-based substratification improves surveillance costs after transurethral resection of bladder tumor in patients with primary high-risk non-muscle-invasive bladder cancer
Abstract High-risk non-muscle-invasive bladder cancer (NMIBC) has a heterogeneity and intensive surveillances after transurethral resection of bladder tumor (TURBT) are major factors of increased costs. Therefore, we aimed to develop optimized surveillance protocols based on the risk score-based sub...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2022-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-17973-8 |
| _version_ | 1828437895058292736 |
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| author | Naoki Fujita Shingo Hatakeyama Masaki Momota Yuki Tobisawa Tohru Yoneyama Hayato Yamamoto Hiroyuki Ito Takahiro Yoneyama Yasuhiro Hashimoto Kazuaki Yoshikawa Chikara Ohyama |
| author_facet | Naoki Fujita Shingo Hatakeyama Masaki Momota Yuki Tobisawa Tohru Yoneyama Hayato Yamamoto Hiroyuki Ito Takahiro Yoneyama Yasuhiro Hashimoto Kazuaki Yoshikawa Chikara Ohyama |
| author_sort | Naoki Fujita |
| collection | DOAJ |
| description | Abstract High-risk non-muscle-invasive bladder cancer (NMIBC) has a heterogeneity and intensive surveillances after transurethral resection of bladder tumor (TURBT) are major factors of increased costs. Therefore, we aimed to develop optimized surveillance protocols based on the risk score-based substratifications to improve surveillance costs. We retrospectively evaluated 428 patients with primary high-risk NMIBC who underwent TURBT. Patients were substratified into intra-lower, intra-intermediate, and intra-higher groups or UUT-lower, UUT-intermediate, and UUT-higher groups by summing each of the independent risk factors of intravesical and UUT recurrences, respectively. The optimized surveillance protocols that enhance cost-effectiveness were then developed using real incidences of recurrence after TURBT. The 10-year total surveillance costs were compared between the European Association of Urology (EAU) guidelines-based and optimized surveillance protocols. The Kaplan–Meier curves of intravesical and UUT recurrence-free survivals were clearly separated among the substratified groups. The optimized surveillance protocols promoted a 43% reduction ($487,599) in the 10-year total surveillance cost compared to the EAU guidelines-based surveillance protocol. These results suggest that the optimized surveillance protocols based on risk score-based substratifications could potentially reduce over investigation and improve surveillance costs after TURBT in patients with primary high-risk NMIBC. |
| first_indexed | 2024-12-10T19:53:57Z |
| format | Article |
| id | doaj.art-54b6cdb9bad54a478a89455063fd293c |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-10T19:53:57Z |
| publishDate | 2022-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-54b6cdb9bad54a478a89455063fd293c2022-12-22T01:35:42ZengNature PortfolioScientific Reports2045-23222022-08-011211910.1038/s41598-022-17973-8Risk score-based substratification improves surveillance costs after transurethral resection of bladder tumor in patients with primary high-risk non-muscle-invasive bladder cancerNaoki Fujita0Shingo Hatakeyama1Masaki Momota2Yuki Tobisawa3Tohru Yoneyama4Hayato Yamamoto5Hiroyuki Ito6Takahiro Yoneyama7Yasuhiro Hashimoto8Kazuaki Yoshikawa9Chikara Ohyama10Department of Urology, Hirosaki University Graduate School of MedicineDepartment of Advanced Blood Purification Therapy, Hirosaki University Graduate School of MedicineDepartment of Urology, Hirosaki University Graduate School of MedicineDepartment of Urology, Hirosaki University Graduate School of MedicineDepartment of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of MedicineDepartment of Urology, Hirosaki University Graduate School of MedicineDepartment of Urology, Aomori Rosai HospitalDepartment of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of MedicineDepartment of Urology, Hirosaki University Graduate School of MedicineDepartment of Urology, Mutsu General HospitalDepartment of Urology, Hirosaki University Graduate School of MedicineAbstract High-risk non-muscle-invasive bladder cancer (NMIBC) has a heterogeneity and intensive surveillances after transurethral resection of bladder tumor (TURBT) are major factors of increased costs. Therefore, we aimed to develop optimized surveillance protocols based on the risk score-based substratifications to improve surveillance costs. We retrospectively evaluated 428 patients with primary high-risk NMIBC who underwent TURBT. Patients were substratified into intra-lower, intra-intermediate, and intra-higher groups or UUT-lower, UUT-intermediate, and UUT-higher groups by summing each of the independent risk factors of intravesical and UUT recurrences, respectively. The optimized surveillance protocols that enhance cost-effectiveness were then developed using real incidences of recurrence after TURBT. The 10-year total surveillance costs were compared between the European Association of Urology (EAU) guidelines-based and optimized surveillance protocols. The Kaplan–Meier curves of intravesical and UUT recurrence-free survivals were clearly separated among the substratified groups. The optimized surveillance protocols promoted a 43% reduction ($487,599) in the 10-year total surveillance cost compared to the EAU guidelines-based surveillance protocol. These results suggest that the optimized surveillance protocols based on risk score-based substratifications could potentially reduce over investigation and improve surveillance costs after TURBT in patients with primary high-risk NMIBC.https://doi.org/10.1038/s41598-022-17973-8 |
| spellingShingle | Naoki Fujita Shingo Hatakeyama Masaki Momota Yuki Tobisawa Tohru Yoneyama Hayato Yamamoto Hiroyuki Ito Takahiro Yoneyama Yasuhiro Hashimoto Kazuaki Yoshikawa Chikara Ohyama Risk score-based substratification improves surveillance costs after transurethral resection of bladder tumor in patients with primary high-risk non-muscle-invasive bladder cancer Scientific Reports |
| title | Risk score-based substratification improves surveillance costs after transurethral resection of bladder tumor in patients with primary high-risk non-muscle-invasive bladder cancer |
| title_full | Risk score-based substratification improves surveillance costs after transurethral resection of bladder tumor in patients with primary high-risk non-muscle-invasive bladder cancer |
| title_fullStr | Risk score-based substratification improves surveillance costs after transurethral resection of bladder tumor in patients with primary high-risk non-muscle-invasive bladder cancer |
| title_full_unstemmed | Risk score-based substratification improves surveillance costs after transurethral resection of bladder tumor in patients with primary high-risk non-muscle-invasive bladder cancer |
| title_short | Risk score-based substratification improves surveillance costs after transurethral resection of bladder tumor in patients with primary high-risk non-muscle-invasive bladder cancer |
| title_sort | risk score based substratification improves surveillance costs after transurethral resection of bladder tumor in patients with primary high risk non muscle invasive bladder cancer |
| url | https://doi.org/10.1038/s41598-022-17973-8 |
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