Objectives: Cost-effectiveness analyses (CEAs) may provide useful data to inform management decisions depending on the robustness of a model's input parameters. We sought to determine the level of heterogeneity in health state utility values, transition probabilities, and cost estimates across published CEAs assessing primarily radiotherapeutic management strategies in prostate cancer.
Methods: We conducted a systematic review of prostate cancer CEAs indexed in MEDLINE between 2000 and 2018 comparing accepted treatment modalities across all cancer stages. Search terms included "cost effectiveness prostate," "prostate cancer cost model," "cost utility prostate," and "Markov AND prostate AND (cancer OR adenocarcinoma)." Included studies were agreed upon. A Markov model was designed using the parameter estimates from the systematic review to evaluate the effect of estimate heterogeneity on strategy cost acceptability.
Results: Of 199 abstracts identified, 47 publications were reviewed and 37 were included; 508 model estimates were compared. Estimates varied widely across variables, including gastrointestinal toxicity risk (0%-49.5%), utility of metastatic disease (0.25-0.855), intensity-modulated radiotherapy cost ($21 193-$61 996), and recurrence after external-beam radiotherapy (1.5%-59%). Multiple studies assumed that different radiotherapy modalities delivering the same dose yielded varying cancer control rates. When using base estimates for similar parameters from included studies, the designed model resulted in 3 separate acceptability determinations.
Conclusions: Significant heterogeneity exists across parameter estimates used to perform CEAs evaluating treatment for prostate cancer. Heterogeneity across model inputs yields variable conclusions with respect to the favorability and cost-effectiveness of treatment options. Decision makers are cautioned to review estimates in CEAs to ensure they are up to date and relevant to setting and population.
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http://dx.doi.org/10.1016/j.jval.2021.08.010 | DOI Listing |
Biomed Eng Online
December 2024
Department of Bioengineering, University of Louisville, Louisville, KY, USA.
Purpose: This study aims to accurately predict the effects of hormonal therapy on prostate cancer (PC) lesions by integrating multi-modality magnetic resonance imaging (MRI) and the clinical marker prostate-specific antigen (PSA). It addresses the limitations of Convolutional Neural Networks (CNNs) in capturing long-range spatial relations and the Vision Transformer (ViT)'s deficiency in localization information due to consecutive downsampling. The research question focuses on improving PC response prediction accuracy by combining both approaches.
View Article and Find Full Text PDFProstate
December 2024
Department of Neurosciences and Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy.
Background: This study aims to assess the relationship between body mass index (BMI) and prostate volume, utilizing pre and postoperative measurements.
Methods: A retrospective, observational study was conducted at a single site using data from an institutional database. Medical records of patients who underwent robot-assisted radical prostatectomy were reviewed.
Appl Biochem Biotechnol
December 2024
Department of Urology, Wuxi Traditional Chinese Medicine Hospital, No. 8 Zhongnan West Road, Binhu District, Wuxi City, 214071, Jiangsu Province, China.
MicroRNA (miR)-328-3p is believed to have anti-tumor impacts in various human cancers. However, its role in prostate cancer (PCa) is uncertain. In this research, miR-328-3p expression in PCa was reduced.
View Article and Find Full Text PDFDiscov Oncol
December 2024
Laboratory of Integrative Oncology, National Cancer Center Research Institute, Tokyo, Japan.
Nuclear receptors, a group of 48 transcription factors that regulate a multitude of processes within our body, have long been employed as diagnostic markers or therapeutic targets in breast cancer, prostate cancer, and acute promyelocytic leukemia. Unfortunately, no comprehensive investigation has been conducted on their significance in other cancer types. The current study aimed to explore novel diagnostic markers by classifying nuclear receptors according to their expression patterns based on transcriptome data from The Cancer Genome Atlas on 10,071 tumor samples across 33 cancer types and investigating their association with genetic mutations, histological types, and prognosis.
View Article and Find Full Text PDFInt J Surg
December 2024
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
Background: The utilization of robot-assisted surgery (RAS) has been increasing among cancer patients. However, evidence supporting the use of RAS remains uncertain. The availability of randomized controlled trials (RCTs) for each surgical procedure is limited.
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