Value of Robot-Assisted Surgery in Renal Cell Carcinoma Accrues Over Time

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Robot-assisted surgery increases access to partial nephrectomy for appropriate patients with kidney cancer.
Robot-assisted surgery increases access to partial nephrectomy for appropriate patients with kidney cancer.

Robot-assisted minimally invasive surgery for kidney cancer is associated with considerable benefits, which outweigh health care and surgical costs, according to a study published in Health Affairs.

Amitabh Chandra, Ph.D., from Harvard University in Cambridge, Mass., and colleagues examined the value of robot-assisted surgery for kidney cancer. They note that kidney cancer is generally treated with partial or radical nephrectomy, with evidence indicating that partial nephrectomy is favored for appropriate patients.

The researchers found that robot-assisted surgery increased access to partial nephrectomy, which correlated with reduced mortality and renal failure.

There was a five to one ratio in terms of the value of benefits of robot-assisted minimally invasive surgery in life-years gained versus the health care and surgical costs to patients and payers. 

Furthermore, there was no evidence to suggest that the availability of robot-assisted minimally invasive surgery increased the likelihood of partial nephrectomy for inappropriate patients.

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"[Our study] suggests that robot-assisted surgery may increase rates of partial nephrectomy among appropriate patients, without increasing inappropriate use of the procedure," the authors write.

"The value of robot-assisted surgery accrues over a long time, whereas the costs are up front. This implies that short-term analyses could mistakenly conclude that the costs of the technology outweigh its benefits."

Three authors disclosed holding positions at Precision Health Economics, which receives funding from Intuitive Surgical and other life science companies; the study was funded by Intuitive Surgical.

Reference

  1. Chandra, Amitabh, et al. "Robot-Assisted Surgery For Kidney Cancer Increased Access To A Procedure That Can Reduce Mortality And Renal Failure." Health Affairs. doi: 10.1377/hlthaff.2014.0986. February 2015.

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