ESTRO 2025 - Abstract Book

S2291

Interdisciplinary – Health economics & health services research

ESTRO 2025

Purpose/Objective: Prostate cancer is the second most common neoplasia worldwide. In Colombia, there are 14,460 new patients with prostate cancer each year. For curative treatment, there are two primary options: surgery or radiotherapy. This study presents a cost-utility analysis of therapy specifically focused on patients with favorable intermediate-risk prostate cancer in Colombia. Material/Methods: A systematic review was conducted in Embase, PubMed, and Cochrane CENTRAL databases to identify relevant publications up to December 2021 to summarize clinical outcomes. A cost-utility study with a decision tree analysis using TreeAge Pro 2022 for favorable intermediate prostate cancer patients was developed. Treatment strategies included in the mode were hypofractionated radiotherapy, stereotactic body radiotherapy, open prostatectomy, and robotic-assisted laparoscopic prostatectomy. Published studies and available data drove the costs, effectiveness, and utilities. Expert opinions were also consulted to adjust data for the model and average the cost of interventions according to available literature data. The incremental cost-utility ratio (ICUR) was calculated. Deterministic and probabilistic sensitivity analyses were performed to evaluate the impact of the uncertainty on the model's conclusions. A willingness to pay (WTP) of 6182,96 USD(one gross domestic product per capita) was chosen.

Results:

In the base case scenario, within different strategies, the robotic-assisted laparoscopic prostatectomy is the most expensive, with an estimated cost of 6,227 USD, and the lowest-cost strategy was the open prostatectomy, with an estimated cost of 2,461 USD. The most effective method was stereotactic body radiotherapy, with a 0.95 QALY (quality adjusted life year); the less effective strategy was open prostatectomy, with a 0.92 QALY. In the sensitivity analysis for the mean Colombian population salary, the hypofractionation radiotherapy, the incremental cost-utility ratio was 5,417 USD per QALY, a cost-effective strategy under the WTP.

Conclusion: In conclusion, open prostatectomy offers the greatest monetary net benefit within the base case scenario. However, hypofractionated radiotherapy emerges as a cost-effective option in Colombia when factoring in costs related to sick leave and patient opportunities.

Keywords: Prostate Cancer, SBRT, Cost-utility