Baniel and colleagues56 found that the choice of nerve-sparing RPLND or surveillance for patients with clinical stage I NSGCT could not be made on the basis of cost as a discriminator. The program for surveillance used in their study included a larger number of control visits and investigations than are seen in most surveillance programs. A cost analysis performed by Francis and colleagues50 showed that a surveillance policy is certainly not more expensive than the other treatment strategies and may in fact be more cost-effective.
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