Comparison of the hospital costs for radical prostatectomy and cryosurgical ablation of the prostate

Objectives. To compare the hospital costs of radical prostatectomy (RP) and cryosurgical ablation of the prostate (CSAP). Methods. All patients who underwent either RP or CSAP at Allegheny General Hospital during an 18-month period beginning in January 1995 were included in this study. Hospital costs were generated for each case, and a chart review was undertaken for each patient. Costs were obtained from the hospital accounting office and divided into Il categories, including total costs. Pretreatment grade, clinical stage, and prostate-specific antigen level were obtained from the patient's chart. Noncost information such as length of stay, number of operating room units charged, and patient age were also obtained from the hospital record. Results. Sixty-seven men underwent RP and 114 men underwent CSAP during the study period. Average hospital costs were $4150 for men undergoing CSAP and $5660 for men undergoing RP, a difference of 27.2% (P < 0.001). The difference in hospital costs was almost completely explained by the difference in room costs ($682 for CSAP and $2348 for RP). Length of stay was 1.1 days for CSAP and 3.5 days for RP. Average operating room costs were higher for CSAP ($2309) than for RP ($1326). Conclusions. As costs become an ever more critical factor in healthcare, the costs of various treatment options for clinically localized prostate cancer will become as important as clinical outcomes in deciding appropriate treatment. From a strictly financial perspective, CSAP is a viable treatment option for clinically localized prostate cancer. (C) 1998, Elsevier Science Inc. All rights reserved.