Comparing the costs of radiation therapy and radical prostatectomy for the initial treatment of XXXX .

@entity1 @entity263 @entity5
PURPOSE: Radical prostatectomy and external-beam radiation are the most common treatments for @entity263 . Given the absence of clinical consensus in favor of one treatment or the other, relative costs may be a significant factor. This study compares the direct medical costs during the month before and 9 months after diagnosis for @entity1 treated primarily with external-beam radiation or radical prostatectomy for @entity5 . METHODS: @entity1 age 65 or older and coded by the Surveillance, Epidemiology, and End Results (SEER) registry as having been diagnosed with @entity263 treated primarily with external-beam radiation or radical prostatectomy during 1992 and 1993 were identified. The initial treatment costs, as measured by Medicare-approved payment amounts, for each strategy were analyzed using linked SEER-Medicare claims data after adjusting for differences in comorbidity and age. An intent-to-treat analysis was also performed to adjust for differences in staging between the two groups. RESULTS: For @entity1 in the treatment-received analysis, the average costs were significantly different;  14,048 (95% confidence interval [CI],  13,765 to  14,330) for radiation therapy and  17,226 (95% CI,  16,891 to  17,560) for radical prostatectomy (P <.001). The average costs for @entity1 in the intent-to-treat analysis were also significantly less for radiation therapy @entity1 ( 14,048; 95% CI,  13,765 to  14,330) than for those who underwent radical prostatectomy ( 17,516; 95% CI,  17,195 to  17,837; P <.001). CONCLUSION: For @entity1 with @entity5 , average costs during the initial treatment interval were at least 23% greater for radical prostatectomy than for external-beam radiation. Major limitations of the research include not studying costs after the initial treatment interval and questionable current applicability, given changes in management of early @entity263 .
