A cost-effectiveness analysis of positron emission tomography-computed tomography surveillance versus up-front neck dissection for management of the neck for N2 disease after chemoradiotherapy.
other · Level V
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- Record sourced from PubMed, PMID 22252963.
- Also identified by DOI 10.1002/lary.22464.
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Abstract
To study the cost effectiveness of positron emission tomography-computerized tomography (PET-CT) scanning in the management of the neck after chemoradiotherapy (CRT). Cost effectiveness and decision analysis model. A cost-effectiveness analysis comparing up-front neck dissection to serial PET-CT imaging in a hypothetical clinical scenario of debate. A patient with an oropharygeal cancer with pretreatment N2 disease having a complete response was considered. Standardized costs were obtained using national databases. A literature review in PubMed was performed to obtain information on incidence, probabilities, and range for various clinical events in the algorithm. PET-CT strategy costs an average of $14,492 per patient. Neck dissection had a 0.6% greater efficacy in controlling neck disease with a $22,433 incremental cost. Our results strongly support the use of PET-CT imaging as the more cost-effective strategy for surveillance of neck after completion of definitive CRT compared to up-front neck dissection.
Medical subject headings
- Antineoplastic Agents
- Carcinoma, Squamous Cell
- Elective Surgical Procedures
- Head and Neck Neoplasms
- Multimodal Imaging
- Neck Dissection
- Positron-Emission Tomography
- Tomography, X-Ray Computed