Comparison of health economics in robot-assisted partial nephrectomy and CT-guided cryoablation for the management of T1 renal cell carcinoma: an analysis of a prospective Danish cohort

Theresa Junker; Mie Gaedt Thorlund; Tommy Kjærgaard Nielsen; Nessn Azawi; Signe Wang Bach; Jonathan Belsey; Jens Borgbjerg; Ole Graumann

doi:10.1007/s00270-025-04224-2

Comparison of health economics in robot-assisted partial nephrectomy and CT-guided cryoablation for the management of T1 renal cell carcinoma: an analysis of a prospective Danish cohort

Theresa Junker^*, Mie Gaedt Thorlund, Tommy Kjærgaard Nielsen, Nessn Azawi, Signe Wang Bach, Jonathan Belsey, Jens Borgbjerg, Ole Graumann

^*Corresponding author for this work

Department of Urology

1 Citation (Scopus)

Abstract

PURPOSE: This study used real-world outcomes data to compare the cost-effectiveness of percutaneous cryoablation (PCA) and robot-assisted partial nephrectomy (RAPN) in patients with T1 renal cell carcinoma (RCC).

MATERIALS AND METHODS: Prospective data from June 2019 to February 2021 from two Danish University hospitals, following patients with RCC stage T1 treated with either PCA or RAPN, were used to provide procedural and clinical outcome parameters. A Markov model was used to estimate quality-adjusted life years (QALYs) and costs, incorporating health states for stable disease, local recurrence, metastasis, and all-cause mortality. Propensity score matching using specific covariates was carried out to ensure that the two populations evaluated were matched. Analyses were conducted comparing time to local recurrence or metastases, duration of hospital stay, and postoperative complications. Treatment-specific mortality was not included in the model due to the low number of deaths observed.

RESULTS: There were no significant differences between PCA and RAPN in terms of local recurrence (HR = 0.80; 95% CI = 0.34-1.85; p = 0.72), metastases (HR = 2.09; 95% CI = 0.69-6.26; p = 0.19), or Clavien-Dindo III + complications (5.5% vs 2.5%; p = 0.325). There were significant differences in the mean duration of hospital stay (1.13 days versus 1.90 days; p < 0.001). QALYs gained were nearly identical for each treatment; however, PCA was associated with a net monetary benefit of €9,045 at a willingness-to-pay threshold of €40,000/QALY.

CONCLUSION: The present study suggests that PCA could equally benefit patients with RCC T1 by providing cost savings, making it a more cost-effective treatment without compromising oncological outcomes.

LEVEL OF EVIDENCE: 2b, Analysis based on clinically sensible costs or alternatives, including multi-way sensitivity analyses.

Original language	English
Journal	Cardiovascular and Interventional Radiology
Volume	49
Issue number	2
Pages (from-to)	278-288
Number of pages	11
ISSN	0174-1551
DOIs	https://doi.org/10.1007/s00270-025-04224-2
Publication status	Published - Feb 2026

Keywords

Aged
Carcinoma, Renal Cell/surgery
Cost-Benefit Analysis
Cryosurgery/economics
Denmark
Female
Humans
Kidney Neoplasms/surgery
Length of Stay
Male
Middle Aged
Neoplasm Staging
Nephrectomy/economics
Prospective Studies
Quality-Adjusted Life Years
Robotic Surgical Procedures/economics
Tomography, X-Ray Computed/economics

Access to Document

10.1007/s00270-025-04224-2Licence: CC BY

Cite this

Junker, T., Thorlund, M. G., Nielsen, T. K., Azawi, N., Bach, S. W., Belsey, J., Borgbjerg, J., & Graumann, O. (2026). Comparison of health economics in robot-assisted partial nephrectomy and CT-guided cryoablation for the management of T1 renal cell carcinoma: an analysis of a prospective Danish cohort. Cardiovascular and Interventional Radiology, 49(2), 278-288. https://doi.org/10.1007/s00270-025-04224-2

Comparison of health economics in robot-assisted partial nephrectomy and CT-guided cryoablation for the management of T1 renal cell carcinoma: an analysis of a prospective Danish cohort. / Junker, Theresa; Thorlund, Mie Gaedt; Nielsen, Tommy Kjærgaard et al.
In: Cardiovascular and Interventional Radiology, Vol. 49, No. 2, 02.2026, p. 278-288.

Research output: Contribution to journal › Journal article › Research › peer-review

Junker, T, Thorlund, MG, Nielsen, TK, Azawi, N, Bach, SW, Belsey, J, Borgbjerg, J & Graumann, O 2026, 'Comparison of health economics in robot-assisted partial nephrectomy and CT-guided cryoablation for the management of T1 renal cell carcinoma: an analysis of a prospective Danish cohort', Cardiovascular and Interventional Radiology, vol. 49, no. 2, pp. 278-288. https://doi.org/10.1007/s00270-025-04224-2

Junker T, Thorlund MG, Nielsen TK, Azawi N, Bach SW, Belsey J et al. Comparison of health economics in robot-assisted partial nephrectomy and CT-guided cryoablation for the management of T1 renal cell carcinoma: an analysis of a prospective Danish cohort. Cardiovascular and Interventional Radiology. 2026 Feb;49(2):278-288. Epub 2025 Oct 15. doi: 10.1007/s00270-025-04224-2

@article{23e75e378aac45628c474d2a985389fc,

title = "Comparison of health economics in robot-assisted partial nephrectomy and CT-guided cryoablation for the management of T1 renal cell carcinoma: an analysis of a prospective Danish cohort",

abstract = "PURPOSE: This study used real-world outcomes data to compare the cost-effectiveness of percutaneous cryoablation (PCA) and robot-assisted partial nephrectomy (RAPN) in patients with T1 renal cell carcinoma (RCC).MATERIALS AND METHODS: Prospective data from June 2019 to February 2021 from two Danish University hospitals, following patients with RCC stage T1 treated with either PCA or RAPN, were used to provide procedural and clinical outcome parameters. A Markov model was used to estimate quality-adjusted life years (QALYs) and costs, incorporating health states for stable disease, local recurrence, metastasis, and all-cause mortality. Propensity score matching using specific covariates was carried out to ensure that the two populations evaluated were matched. Analyses were conducted comparing time to local recurrence or metastases, duration of hospital stay, and postoperative complications. Treatment-specific mortality was not included in the model due to the low number of deaths observed.RESULTS: There were no significant differences between PCA and RAPN in terms of local recurrence (HR = 0.80; 95\% CI = 0.34-1.85; p = 0.72), metastases (HR = 2.09; 95\% CI = 0.69-6.26; p = 0.19), or Clavien-Dindo III + complications (5.5\% vs 2.5\%; p = 0.325). There were significant differences in the mean duration of hospital stay (1.13 days versus 1.90 days; p < 0.001). QALYs gained were nearly identical for each treatment; however, PCA was associated with a net monetary benefit of €9,045 at a willingness-to-pay threshold of €40,000/QALY.CONCLUSION: The present study suggests that PCA could equally benefit patients with RCC T1 by providing cost savings, making it a more cost-effective treatment without compromising oncological outcomes.LEVEL OF EVIDENCE: 2b, Analysis based on clinically sensible costs or alternatives, including multi-way sensitivity analyses.",

keywords = "Aged, Carcinoma, Renal Cell/surgery, Cost-Benefit Analysis, Cryosurgery/economics, Denmark, Female, Humans, Kidney Neoplasms/surgery, Length of Stay, Male, Middle Aged, Neoplasm Staging, Nephrectomy/economics, Prospective Studies, Quality-Adjusted Life Years, Robotic Surgical Procedures/economics, Tomography, X-Ray Computed/economics",

author = "Theresa Junker and Thorlund, \{Mie Gaedt\} and Nielsen, \{Tommy Kj{\ae}rgaard\} and Nessn Azawi and Bach, \{Signe Wang\} and Jonathan Belsey and Jens Borgbjerg and Ole Graumann",

note = "{\textcopyright} 2025. The Author(s).",

year = "2026",

month = feb,

doi = "10.1007/s00270-025-04224-2",

language = "English",

volume = "49",

pages = "278--288",

journal = "Cardiovascular and Interventional Radiology",

issn = "0174-1551",

publisher = "Springer",

number = "2",

}

TY - JOUR

T1 - Comparison of health economics in robot-assisted partial nephrectomy and CT-guided cryoablation for the management of T1 renal cell carcinoma

T2 - an analysis of a prospective Danish cohort

AU - Junker, Theresa

AU - Thorlund, Mie Gaedt

AU - Nielsen, Tommy Kjærgaard

AU - Azawi, Nessn

AU - Bach, Signe Wang

AU - Belsey, Jonathan

AU - Borgbjerg, Jens

AU - Graumann, Ole

PY - 2026/2

Y1 - 2026/2

N2 - PURPOSE: This study used real-world outcomes data to compare the cost-effectiveness of percutaneous cryoablation (PCA) and robot-assisted partial nephrectomy (RAPN) in patients with T1 renal cell carcinoma (RCC).MATERIALS AND METHODS: Prospective data from June 2019 to February 2021 from two Danish University hospitals, following patients with RCC stage T1 treated with either PCA or RAPN, were used to provide procedural and clinical outcome parameters. A Markov model was used to estimate quality-adjusted life years (QALYs) and costs, incorporating health states for stable disease, local recurrence, metastasis, and all-cause mortality. Propensity score matching using specific covariates was carried out to ensure that the two populations evaluated were matched. Analyses were conducted comparing time to local recurrence or metastases, duration of hospital stay, and postoperative complications. Treatment-specific mortality was not included in the model due to the low number of deaths observed.RESULTS: There were no significant differences between PCA and RAPN in terms of local recurrence (HR = 0.80; 95% CI = 0.34-1.85; p = 0.72), metastases (HR = 2.09; 95% CI = 0.69-6.26; p = 0.19), or Clavien-Dindo III + complications (5.5% vs 2.5%; p = 0.325). There were significant differences in the mean duration of hospital stay (1.13 days versus 1.90 days; p < 0.001). QALYs gained were nearly identical for each treatment; however, PCA was associated with a net monetary benefit of €9,045 at a willingness-to-pay threshold of €40,000/QALY.CONCLUSION: The present study suggests that PCA could equally benefit patients with RCC T1 by providing cost savings, making it a more cost-effective treatment without compromising oncological outcomes.LEVEL OF EVIDENCE: 2b, Analysis based on clinically sensible costs or alternatives, including multi-way sensitivity analyses.

AB - PURPOSE: This study used real-world outcomes data to compare the cost-effectiveness of percutaneous cryoablation (PCA) and robot-assisted partial nephrectomy (RAPN) in patients with T1 renal cell carcinoma (RCC).MATERIALS AND METHODS: Prospective data from June 2019 to February 2021 from two Danish University hospitals, following patients with RCC stage T1 treated with either PCA or RAPN, were used to provide procedural and clinical outcome parameters. A Markov model was used to estimate quality-adjusted life years (QALYs) and costs, incorporating health states for stable disease, local recurrence, metastasis, and all-cause mortality. Propensity score matching using specific covariates was carried out to ensure that the two populations evaluated were matched. Analyses were conducted comparing time to local recurrence or metastases, duration of hospital stay, and postoperative complications. Treatment-specific mortality was not included in the model due to the low number of deaths observed.RESULTS: There were no significant differences between PCA and RAPN in terms of local recurrence (HR = 0.80; 95% CI = 0.34-1.85; p = 0.72), metastases (HR = 2.09; 95% CI = 0.69-6.26; p = 0.19), or Clavien-Dindo III + complications (5.5% vs 2.5%; p = 0.325). There were significant differences in the mean duration of hospital stay (1.13 days versus 1.90 days; p < 0.001). QALYs gained were nearly identical for each treatment; however, PCA was associated with a net monetary benefit of €9,045 at a willingness-to-pay threshold of €40,000/QALY.CONCLUSION: The present study suggests that PCA could equally benefit patients with RCC T1 by providing cost savings, making it a more cost-effective treatment without compromising oncological outcomes.LEVEL OF EVIDENCE: 2b, Analysis based on clinically sensible costs or alternatives, including multi-way sensitivity analyses.

KW - Aged

KW - Carcinoma, Renal Cell/surgery

KW - Cost-Benefit Analysis

KW - Cryosurgery/economics

KW - Denmark

KW - Female

KW - Humans

KW - Kidney Neoplasms/surgery

KW - Length of Stay

KW - Male

KW - Middle Aged

KW - Neoplasm Staging

KW - Nephrectomy/economics

KW - Prospective Studies

KW - Quality-Adjusted Life Years

KW - Robotic Surgical Procedures/economics

KW - Tomography, X-Ray Computed/economics

UR - https://www.scopus.com/pages/publications/105019210749

U2 - 10.1007/s00270-025-04224-2

DO - 10.1007/s00270-025-04224-2

M3 - Journal article

C2 - 41094074

SN - 0174-1551

VL - 49

SP - 278

EP - 288

JO - Cardiovascular and Interventional Radiology

JF - Cardiovascular and Interventional Radiology

IS - 2

ER -

Comparison of health economics in robot-assisted partial nephrectomy and CT-guided cryoablation for the management of T1 renal cell carcinoma: an analysis of a prospective Danish cohort

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this