Editorial comment: understanding the cost of bladder preservation in muscle invasive bladder cancer—an evaluation of radical cystectomy versus trimodal therapy costs

Diana E. Magee, Girish S. Kulkarni


Bladder cancer represents a significant source of morbidity and mortality worldwide. Nearly 430,000 diagnoses of bladder cancer are made each year leading to approximately 165,000 deaths (1). Within the context of healthcare spending it is a costly diagnosis and has been reported as the most expensive diagnosis per patient lifetime among all cancers (2,3), with a total cost of almost $4 billion annually in the United States in 2010 (4). Previous studies have shown that radical cystectomy (RC) accounts for the largest proportion of costs associated with bladder cancer care (5); however, few studies have evaluated the cost of trimodal therapy (TMT). TMT has progressively been accepted as a viable treatment option for the treatment of muscle-invasive bladder cancer (MIBC) (6-8) and therefore the implications from a healthcare economic perspective have become increasingly important to consider.