title: [Treatment of small renal masses: Effectiveness and cost-comparison analysis].
abstract: OBJECTIVE
  The stage of discovery and treatment of kidney cancer have changed. Partial nephrectomy is the standard treatment for small renal masses (SRM). Also are recommended the thermal ablative techniques. The cost of these treatments for the establishment and society is often unclear. The purpose of this study was to calculate the cost of treatment of SRM in order to assess the profitability for a health institution that invests in innovation.
  
  
  METHODS
  A retrospective single-center study was conducted with 124 patients treated for SMR (T1a) by open partial nephrectomy (OPN), laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (LRPN), radio frequency (RF) and cryotherapy (CT) between 2009 and 2011. We calculated the price of stay of each patient, searched the amount billed to health insurance and calculated the profitability of treatment for the establishment.
  
  
  RESULTS
  The OPN cost on average 7884±1201€ and reported 451±1861€, the LPN cost on average 6973±3503€ and reported 2271±3370€, the cost of the LRPN was on average 9600±4595€ and resulted in a deficit of 838±3007€. The radiofrequency cost on average 2724±813€ and caused a deficit of 954±684€, cryotherapy cost on average 6702±857€ and resulted in a deficit of 4723±941€.
  
  
  CONCLUSIONS
  According to current repayment terms, the LPN was the treatment of SRM that offered the best profitability.
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, centre hospitalo-universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, TSA 50032, 31059 Toulouse cedex 9, France. Electronic address: juliepiechaud@yahoo.fr.
authors.forename: J
authors.initials: J
authors.lastname: Piechaud-Kressmann
authors.affiliation: Clinique de l'Union, boulevard de Ratalens, BP 24336, 31240 Saint-Jean, France.
authors.forename: L
authors.initials: L
authors.lastname: Bellec
authors.affiliation: Service d'imagerie, centre hospitalo-universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: M-C
authors.initials: MC
authors.lastname: Delchier-Bellec
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, centre hospitalo-universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: J-B
authors.initials: JB
authors.lastname: Beauval
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, centre hospitalo-universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Roumiguié
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, centre hospitalo-universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: X
authors.initials: X
authors.lastname: Gamé
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, centre hospitalo-universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Soulie
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, centre hospitalo-universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: P
authors.initials: P
authors.lastname: Rischmann
authors.affiliation: Département d'urologie, transplantation rénale et andrologie, centre hospitalo-universitaire de Toulouse, 1, avenue du Professeur-Jean-Poulhes, TSA 50032, 31059 Toulouse cedex 9, France; Département de chirurgie oncologique, IUCT-oncopôle, 1, avenue Irène-Joliot-Curie, 31059 Toulouse cedex 9, France.
authors.forename: B
authors.initials: B
authors.lastname: Malavaud
mesh_terms: D055011:Ablation Techniques / Q000191:economics; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003365:Costs and Cost Analysis; D003452:Cryosurgery / Q000191:economics; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000191:economics; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult
keywords: Comparaison des coûts; Cost-comparison; Nephron sparing surgery; Renal tumor; Tumeur rénale; Épargne néphronique