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Start Over Author "Saigal" Journal the journal of urology
238 results on '"Saigal"'

2. Relief of Urinary Symptom Burden after Primary Prostate Cancer Treatment

Author

Chang, Peter, Regan, Meredith M., Ferrer, Montserrat, Guedea, Ferran, Patil, Dattatraya, Wei, John T., Hembroff, Larry A., Michalski, Jeff M., Saigal, Chris S., Litwin, Mark S., Hamstra, Daniel A., Kaplan, Irving D., Ciezki, Jay P., Klein, Eric A., Kibel, Adam S., Sandler, Howard M., Dunn, Rodney L., Crociani, Catrina M., and Sanda, Martin G.

Published
2017
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32. Prospective Multicenter Comparison of Open and Robotic Radical Prostatectomy: The PROST-QA/RP2 Consortium

Author

John T. Wei, Catrina Crociani, Adam S. Kibel, Mark S. Litwin, Peter Chang, Misop Han, Larry Hembroff, Peter R. Carroll, Linda Stork, Christopher S. Saigal, Joseph A. Smith, Daniel E. Spratt, Meredith M. Regan, Dattatraya Patil, David P. Wood, Kyle Davis, Eric A. Klein, Jim C. Hu, Matthew R. Cooperberg, Alan W. Partin, Martin G. Sanda, Gerald L. Andriole, Thomas K. Greenfield, and Andrew A. Wagner

Subjects
Male, medicine.medical_specialty, Urology, medicine.medical_treatment, Article, Prostate cancer, Quality of life, Robotic Surgical Procedures, medicine, Humans, Prospective Studies, Aged, Prostatectomy, Surgical approach, business.industry, Cancer, Prostatic Neoplasms, Perioperative, Middle Aged, medicine.disease, Neck of urinary bladder, Treatment Outcome, Quality of Life, Lymphadenectomy, Laparoscopy, business
Abstract

PURPOSE: To evaluate the comparative effectiveness of robot-assisted laparoscopic prostatectomy (RALP) and open radical prostatectomy (ORP) in a multicenter study. MATERIALS AND METHODS: We evaluated men with localized prostate cancer at eleven high-volume academic medical centers in the United States from the PROST-QA (2003–2006) and the PROST-QA/RP2 cohorts (2010–2013) with a pre-specified goal of comparing RALP (N = 549) and ORP (N = 545). We measured longitudinal patient-reported health related quality of life (HRQOL) at pre-treatment, 2, 6, 12, and 24 months, and pathologic and peri-operative outcomes/complications. RESULTS: Demographics, cancer characteristics, and margin status were similar between surgical approaches. ORP subjects were more likely to undergo lymphadenectomy (89% vs 47%; p

Published
2021

47. Cost-Effectiveness Analysis of Pembrolizumab for Bacillus Calmette-Guérin-Unresponsive Carcinoma In Situ of the Bladder

Author

Mark S. Litwin, Bijan J. Borah, Vignesh T. Packiam, Kevin Wymer, Matthew Mossanen, Vidit Sharma, Christopher S. Saigal, Lance C. Pagliaro, Karim Chamie, and Stephen A. Boorjian

Subjects
Oncology, medicine.medical_specialty, Urology, medicine.medical_treatment, Cost-Benefit Analysis, Pembrolizumab, Antibodies, Monoclonal, Humanized, Cystectomy, Antineoplastic Agents, Immunological, Adjuvants, Immunologic, Internal medicine, medicine, Humans, Treatment Failure, Bacillus (shape), Bladder cancer, biology, business.industry, Carcinoma in situ, Immunotherapy, Cost-effectiveness analysis, medicine.disease, biology.organism_classification, Urinary Bladder Neoplasms, BCG Vaccine, Intravesical chemotherapy, business, Carcinoma in Situ
Abstract

Patients with bacillus Calmette-Guérin-unresponsive carcinoma in situ are treated with radical cystectomy or salvage intravesical chemotherapy. Recently, pembrolizumab was approved for bacillus Calmette-Guérin-unresponsive carcinoma in situ.We used a decision-analytic Markov model to compare pembrolizumab, salvage intravesical chemotherapy (with gemcitabine-docetaxel induction+monthly maintenance) and radical cystectomy for patients with bacillus Calmette-Guérin-unresponsive carcinoma in situ who are radical cystectomy candidates (index patient 1) or are unwilling/unable to undergo radical cystectomy (index patient 2). The model used a U.S. Medicare perspective with a 5-year time horizon. One-way and probabilistic sensitivity analyses were performed. Incremental cost-effectiveness ratios were compared using a willingness to pay threshold of $100,000/quality-adjusted life year.For index patient 1, pembrolizumab was not cost-effective relative to radical cystectomy (incremental cost-effectiveness ratios $1,403,008/quality-adjusted life year) or salvage intravesical chemotherapy (incremental cost-effectiveness ratios $2,011,923/quality-adjusted life year). One-way sensitivity analysis revealed that pembrolizumab only became cost-effective relative to radical cystectomy with a93% price reduction. Relative to radical cystectomy, salvage intravesical chemotherapy was cost-effective for time horizons5 years and nearly cost-effective at 5 years (incremental cost-effectiveness ratios $118,324/quality-adjusted life year). One-way sensitivity analysis revealed that salvage intravesical chemotherapy became cost-effective relative to radical cystectomy if risk of recurrence or metastasis at 2 years was less than 55% or 5.9%, respectively. For index patient 2, pembrolizumab required90% price reduction to be cost-effective (incremental cost-effectiveness ratios $1,073,240/quality-adjusted life year). Pembrolizumab was cost-effective in 0% of 100,000 microsimulations in probabilistic sensitivity analyses for both index patients.At its current price, pembrolizumab is not cost-effective for bacillus Calmette-Guérin-unresponsive carcinoma in situ relative to radical cystectomy or salvage intravesical chemotherapy. Although gemcitabine-docetaxel is not cost-effective relative to radical cystectomy at 5 years, further studies may validate its cost-effectiveness if recurrence and metastasis thresholds are met.

Published
2020

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