, Volume 37, Issue 3, pp 301–331 | Cite as

Economic Burden of Renal Cell Carcinoma—Part I: An Updated Review

  • Chun-Ru Chien
  • Daniel M. Geynisman
  • Bumyang Kim
  • Ying Xu
  • Ya-Chen Tina ShihEmail author
Review Article



The economic burden of renal cell carcinoma (RCC) had been reported to be significant in a previous review published in 2011.


The objective of this study was to perform an updated review by synthesizing economic studies related to the treatment of RCC that have been published since the previous review.


We performed a literature search in PubMed, EMBASE, and the Cochrane Library, covering English-language studies published between June 2010 and August 2018. We categorized these articles by type of analyses [cost-effectiveness analysis (CEA), cost analysis, and cost of illness (COI)] and treatment setting (cancer status and treatment), discussed findings from these articles, and synthesized information from each article in summary tables.


We identified 52 studies from 2317 abstracts/titles deemed relevant from the initial search, including 21 CEA, 23 cost analysis, and 8 COI studies. For localized RCC, costs were found to be positively associated with the aggressiveness of the local treatment. For metastatic RCC (mRCC), pazopanib was reported to be cost effective in the first-line setting. We also found that the economic burden of RCC has increased over time.


RCC continues to impose a substantial economic burden to the healthcare system. Despite the large number of treatment alternatives now available for advanced RCC, the cost effectiveness and budgetary impact of many new agents remain unknown and warrant greater attention in future research.



The authors thank Dr. Gary Deyter, technical writer from the Department of Health Services Research, The University of Texas MD Anderson Cancer Center, for his editorial contribution.

Data Availability Statement

The data (i.e. Excel file of all abstracts reviewed for this study) generated for the current study are available from the corresponding author upon reasonable request.

Author Contributions

Dr. Chien contributed to the study design; acquisition, analysis, and interpretation of the data; and drafting of the manuscript. Drs. Geynisman and Xu contributed to critical review of the manuscripts identified as a result of the search criteria, and commented on the interpretation of the study findings and critical revisions to the manuscript. Dr. Kim contributed to data analysis, information synthesis, and critical reviews/comments. Dr. Shih provided administrative support and senior supervision, and also contributed to the study design; acquisition, analysis, and interpretation of the data; and editing/revising each version of the draft manuscript. All authors approved the final version submitted for publication and agreed to be accountable for all aspects of the work. Dr. Shih acts as the overall guarantor.

Compliance with ethical standards


We acknowledge funding from the China Medical University Hospital (Chien: CRS-106-040) and the National Cancer Institute (Shih: R01 CA207216 and CCSG P30 CA016672).

Conflicts of Interest

Drs. Chien, Geynisman, Xu, Kim, and Shih have no conflicts of interest (either financial or non-financial) to disclose.

Supplementary material

40273_2018_746_MOESM1_ESM.docx (29 kb)
Supplementary material 1 (DOCX 29 kb)


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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • Chun-Ru Chien
    • 1
    • 2
  • Daniel M. Geynisman
    • 3
  • Bumyang Kim
    • 4
  • Ying Xu
    • 4
  • Ya-Chen Tina Shih
    • 4
    Email author
  1. 1.Department of Radiation OncologyChina Medical University HospitalTaichungTaiwan
  2. 2.School of Medicine, College of MedicineChina Medical UniversityTaichungTaiwan
  3. 3.Department of Medical OncologyFox Chase Cancer Center, Temple HealthPhiladelphiaUSA
  4. 4.Section of Cancer Economics and Policy, Department of Health Services ResearchUniversity of Texas MD Anderson Cancer CenterHoustonUSA

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