Survival gains needed to offset persistent adverse treatment effects in localised prostate cancer

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dc.contributor.author King, M en_US
dc.contributor.author Viney, Rosalie en_US
dc.contributor.author Smith, D en_US
dc.contributor.author Hossain, Ishrat en_US
dc.contributor.author Street, Deborah en_US
dc.contributor.author Savage, Elizabeth en_US
dc.contributor.author Fowler, Sandy en_US
dc.contributor.author Berry, Marilyn en_US
dc.contributor.author Stockler, Martin en_US
dc.contributor.author Cozzi, Paul en_US
dc.contributor.author Stricker, Phillip en_US
dc.contributor.author Ward, J en_US
dc.contributor.author Armstrong, Bk en_US
dc.contributor.editor en_US
dc.date.accessioned 2012-10-12T03:34:55Z
dc.date.available 2012-10-12T03:34:55Z
dc.date.issued 2012 en_US
dc.identifier 2010006514 en_US
dc.identifier.citation King M et al. 2012, 'Survival gains needed to offset persistent adverse treatment effects in localised prostate cancer', Nature Publishing Group, vol. 106, no. 4, pp. 638-645. en_US
dc.identifier.issn 0007-0920 en_US
dc.identifier.other C1 en_US
dc.identifier.uri http://hdl.handle.net/10453/18819
dc.description.abstract Men diagnosed with localised prostate cancer (LPC) face difficult choices between treatment options that can cause persistent problems with sexual, urinary and bowel function. Controlled trial evidence about the survival benefits of the full range of treatment alternatives is limited, and patients' views on the survival gains that might justify these problems have not been quantified. A discrete choice experiment (DCE) was administered in a random subsample (n = 357, stratified by treatment) of a population-based sample (n = 1381) of men, recurrence-free 3 years after diagnosis of LPC, and 65 age-matched controls (without prostate cancer). Survival gains needed to justify persistent problems were estimated by substituting side effect and survival parameters from the DCE into an equation for compensating variation (adapted from welfare economics). Median (2.5, 97.5 centiles) survival benefits needed to justify severe erectile dysfunction and severe loss of libido were 4.0 (3.4, 4.6) and 5.0 (4.9, 5.2) months. These problems were common, particularly after androgen deprivation therapy (ADT): 40 and 41% overall (n = 1381) and 88 and 78% in the ADT group (n = 33). Urinary leakage (most prevalent after radical prostatectomy (n - 839, mild 41%, severe 18%)) needed 4.2 (4.1, 4.3) and 27.7 (26.9, 28.5) months survival benefit, respectively. Mild bowel problems (most prevalent (30%) after external beam radiotherapy (n = 106)) needed 6.2 (6.1, 6.4) months survival benefit. en_US
dc.language en_US
dc.publisher Nature Publishing Group en_US
dc.relation.isbasedon http://dx.doi.org/10.1038/bjc.2011.552 en_US
dc.title Survival gains needed to offset persistent adverse treatment effects in localised prostate cancer en_US
dc.parent British Journal Of Cancer en_US
dc.journal.volume 106 en_US
dc.journal.number 4 en_US
dc.publocation London, UK en_US
dc.identifier.startpage 638 en_US
dc.identifier.endpage 645 en_US
dc.cauo.name BUS.Faculty of Business en_US
dc.conference Verified OK en_US
dc.for 140208 en_US
dc.personcode 0000071665 en_US
dc.personcode 020117 en_US
dc.personcode 0000071667 en_US
dc.personcode 031002 en_US
dc.personcode 950324 en_US
dc.personcode 020120 en_US
dc.personcode 0000022432 en_US
dc.personcode 944572 en_US
dc.personcode STOCM en_US
dc.personcode 0000059271 en_US
dc.personcode 0000032246 en_US
dc.personcode 0000071671 en_US
dc.personcode 0000036135 en_US
dc.percentage 100 en_US
dc.classification.name Health Economics en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
dc.description.keywords preferences; prostate cancer; quality of life; survival benefit; trade-off; utility en_US


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