title: Surgical advances in bladder cancer: at what cost?
abstract: Bladder cancer is the most expensive cancer to treat from diagnosis to death. Frequent disease recurrence, intense follow-up, and expensive, invasive techniques for diagnosis and treatment drive these costs for non-muscle invasive bladder cancer. Fluorescence cystoscopy increases the detection of superficial bladder cancer and reduces costs by improving the quality of resection and reducing recurrences. Radical cystectomy with intestinal diversion is the mainstay of treatment of invasive disease; however it is associated with substantial cost and morbidity. Increased efforts to improve the surgical management of bladder cancer while reducing the cost of treatment are increasingly necessary.
authors.affiliation: Department of Urology, University of North Carolina, School of Medicine, 2113 Physician's Office Building, 170 Manning Drive, CB 7235, Chapel Hill, NC 27599, USA. Electronic address: David.Johnson3@unchealth.unc.edu.
authors.forename: David C
authors.initials: DC
authors.lastname: Johnson
authors.affiliation: Department of Urology, University of North Carolina, School of Medicine, 2113 Physician's Office Building, 170 Manning Drive, CB 7235, Chapel Hill, NC 27599, USA.
authors.forename: Peter S
authors.initials: PS
authors.lastname: Greene
authors.affiliation: Department of Urology, University of North Carolina, School of Medicine, 2113 Physician's Office Building, 170 Manning Drive, CB 7235, Chapel Hill, NC 27599, USA.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Nielsen
mesh_terms: D003362:Cost-Benefit Analysis; D015653:Cystectomy / Q000009:adverse effects / Q000191:economics; D003558:Cystoscopy / Q000009:adverse effects / Q000191:economics; D005765:Gastrointestinal Agents / Q000191:economics / Q000627:therapeutic use; D017048:Health Care Costs; D006801:Humans; D045823:Ileus / Q000191:economics / Q000209:etiology / Q000517:prevention & control; D007902:Length of Stay / Q000191:economics; D010880:Piperidines / Q000191:economics / Q000627:therapeutic use; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000191:economics; D001749:Urinary Bladder Neoplasms / Q000191:economics / Q000473:pathology / Q000601:surgery*
chemical_list: D005765:Gastrointestinal Agents; D010880:Piperidines; C419502:alvimopan
keywords: Alvimopan; Bladder cancer; Blue-light cystoscopy; Costs; Quality of life; Robotic cystectomy