Transoral Robotic Surgery and the Unknown Primary: A Cost-Effective Technique to Identify the Tumor
Identifieur interne : 001573 ( Pmc/Curation ); précédent : 001572; suivant : 001574Transoral Robotic Surgery and the Unknown Primary: A Cost-Effective Technique to Identify the Tumor
Auteurs : J. Kenneth Byrd [États-Unis] ; Kenneth J. Smith [États-Unis] ; John R. De Almeida [Canada] ; W. Greer Albergotti [États-Unis] ; Kara S. Davis [États-Unis] ; Seungwon W. Kim [États-Unis] ; Jonas T. Johnson [États-Unis] ; Robert L. Ferris [États-Unis] ; Umamaheswar Duvvuri [États-Unis]Source :
- Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery [ 0194-5998 ] ; 2014.
Abstract
To evaluate the cost-effectiveness of transoral robotic surgery (TORS) for diagnosis and treatment of cervical unknown primary squamous cell carcinoma (CUP).
Retrospective Review
A retrospective chart review was performed on patients with new occult primary squamous cell carcinoma of the head and neck with non-diagnostic imaging and/or endoscopy who were treated with TORS at a tertiary hospital between 2009 and 2012. Direct costs ($) were obtained from the hospital’s billing system, and national data were used for inpatient hospital costs and physician fees. The proportion of tumors found in three strategies was used as effectiveness to calculate the incremental cost-effectiveness ratio.
206 head and neck robotic cases were performed at our institution between December 2009 and December 2012. Three surgeons performed TORS on 22 patients for occult primary squamous cell carcinoma. The primary tumor was located in 19/22 (86.4%) patients. The incremental cost-effectiveness ratio for sequential and simultaneous EUA and TORS base of tongue resection was $8619 and $5774 per additional primary identified, respectively.
TORS is a cost-effective procedure to locate the primary tumor in patients with cervical lymph node metastases and no obvious source. Bilateral base of tongue resection should be considered as part of the exam under anesthesia for these patients, particularly if the palatine tonsils have already been removed.
Url:
DOI: 10.1177/0194599814525746
PubMed: 24618502
PubMed Central: 4167971
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: Pour aller vers cette notice dans l'étape Curation :001598
Links to Exploration step
PMC:4167971Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Transoral Robotic Surgery and the Unknown Primary: A Cost-Effective Technique to Identify the Tumor</title><author><name sortKey="Byrd, J Kenneth" sort="Byrd, J Kenneth" uniqKey="Byrd J" first="J. Kenneth" last="Byrd">J. Kenneth Byrd</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Smith, Kenneth J" sort="Smith, Kenneth J" uniqKey="Smith K" first="Kenneth J." last="Smith">Kenneth J. Smith</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="De Almeida, John R" sort="De Almeida, John R" uniqKey="De Almeida J" first="John R." last="De Almeida">John R. De Almeida</name><affiliation wicri:level="4"><nlm:aff id="A3">Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON</nlm:aff><orgName type="university">Université de Toronto</orgName><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Albergotti, W Greer" sort="Albergotti, W Greer" uniqKey="Albergotti W" first="W. Greer" last="Albergotti">W. Greer Albergotti</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Davis, Kara S" sort="Davis, Kara S" uniqKey="Davis K" first="Kara S." last="Davis">Kara S. Davis</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Kim, Seungwon W" sort="Kim, Seungwon W" uniqKey="Kim S" first="Seungwon W." last="Kim">Seungwon W. Kim</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Johnson, Jonas T" sort="Johnson, Jonas T" uniqKey="Johnson J" first="Jonas T." last="Johnson">Jonas T. Johnson</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Ferris, Robert L" sort="Ferris, Robert L" uniqKey="Ferris R" first="Robert L." last="Ferris">Robert L. Ferris</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Duvvuri, Umamaheswar" sort="Duvvuri, Umamaheswar" uniqKey="Duvvuri U" first="Umamaheswar" last="Duvvuri">Umamaheswar Duvvuri</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">24618502</idno><idno type="pmc">4167971</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4167971</idno><idno type="RBID">PMC:4167971</idno><idno type="doi">10.1177/0194599814525746</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">001598</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">001598</idno><idno type="wicri:Area/Pmc/Curation">001573</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">001573</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Transoral Robotic Surgery and the Unknown Primary: A Cost-Effective Technique to Identify the Tumor</title><author><name sortKey="Byrd, J Kenneth" sort="Byrd, J Kenneth" uniqKey="Byrd J" first="J. Kenneth" last="Byrd">J. Kenneth Byrd</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Smith, Kenneth J" sort="Smith, Kenneth J" uniqKey="Smith K" first="Kenneth J." last="Smith">Kenneth J. Smith</name><affiliation wicri:level="2"><nlm:aff id="A2">Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="De Almeida, John R" sort="De Almeida, John R" uniqKey="De Almeida J" first="John R." last="De Almeida">John R. De Almeida</name><affiliation wicri:level="4"><nlm:aff id="A3">Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON</nlm:aff><orgName type="university">Université de Toronto</orgName><country>Canada</country><placeName><settlement type="city">Toronto</settlement><region type="state">Ontario</region></placeName></affiliation></author><author><name sortKey="Albergotti, W Greer" sort="Albergotti, W Greer" uniqKey="Albergotti W" first="W. Greer" last="Albergotti">W. Greer Albergotti</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Davis, Kara S" sort="Davis, Kara S" uniqKey="Davis K" first="Kara S." last="Davis">Kara S. Davis</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Kim, Seungwon W" sort="Kim, Seungwon W" uniqKey="Kim S" first="Seungwon W." last="Kim">Seungwon W. Kim</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Johnson, Jonas T" sort="Johnson, Jonas T" uniqKey="Johnson J" first="Jonas T." last="Johnson">Jonas T. Johnson</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Ferris, Robert L" sort="Ferris, Robert L" uniqKey="Ferris R" first="Robert L." last="Ferris">Robert L. Ferris</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author><author><name sortKey="Duvvuri, Umamaheswar" sort="Duvvuri, Umamaheswar" uniqKey="Duvvuri U" first="Umamaheswar" last="Duvvuri">Umamaheswar Duvvuri</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</nlm:aff><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh</wicri:cityArea></affiliation></author></analytic><series><title level="j">Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery</title><idno type="ISSN">0194-5998</idno><idno type="eISSN">1097-6817</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To evaluate the cost-effectiveness of transoral robotic surgery (TORS) for diagnosis and treatment of cervical unknown primary squamous cell carcinoma (CUP).</p></sec><sec id="S2"><title>Study Design</title><p id="P2">Retrospective Review</p></sec><sec id="S3"><title>Subjects and Methods</title><p id="P3">A retrospective chart review was performed on patients with new occult primary squamous cell carcinoma of the head and neck with non-diagnostic imaging and/or endoscopy who were treated with TORS at a tertiary hospital between 2009 and 2012. Direct costs ($) were obtained from the hospital’s billing system, and national data were used for inpatient hospital costs and physician fees. The proportion of tumors found in three strategies was used as effectiveness to calculate the incremental cost-effectiveness ratio.</p></sec><sec id="S4"><title>Results</title><p id="P4">206 head and neck robotic cases were performed at our institution between December 2009 and December 2012. Three surgeons performed TORS on 22 patients for occult primary squamous cell carcinoma. The primary tumor was located in 19/22 (86.4%) patients. The incremental cost-effectiveness ratio for sequential and simultaneous EUA and TORS base of tongue resection was $8619 and $5774 per additional primary identified, respectively.</p></sec><sec id="S5"><title>Conclusion</title><p id="P5">TORS is a cost-effective procedure to locate the primary tumor in patients with cervical lymph node metastases and no obvious source. Bilateral base of tongue resection should be considered as part of the exam under anesthesia for these patients, particularly if the palatine tonsils have already been removed.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8508176</journal-id><journal-id journal-id-type="pubmed-jr-id">6324</journal-id><journal-id journal-id-type="nlm-ta">Otolaryngol Head Neck Surg</journal-id><journal-id journal-id-type="iso-abbrev">Otolaryngol Head Neck Surg</journal-id><journal-title-group><journal-title>Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery</journal-title></journal-title-group><issn pub-type="ppub">0194-5998</issn><issn pub-type="epub">1097-6817</issn></journal-meta><article-meta><article-id pub-id-type="pmid">24618502</article-id><article-id pub-id-type="pmc">4167971</article-id><article-id pub-id-type="doi">10.1177/0194599814525746</article-id><article-id pub-id-type="manuscript">NIHMS627306</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Transoral Robotic Surgery and the Unknown Primary: A Cost-Effective Technique to Identify the Tumor</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Byrd</surname><given-names>J. Kenneth</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Smith</surname><given-names>Kenneth J.</given-names></name><degrees>MS, MD</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>de Almeida</surname><given-names>John R.</given-names></name><degrees>MSc, MD</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Albergotti</surname><given-names>W. Greer</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Davis</surname><given-names>Kara S.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kim</surname><given-names>Seungwon W.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Johnson</surname><given-names>Jonas T.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Ferris</surname><given-names>Robert L.</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Duvvuri</surname><given-names>Umamaheswar</given-names></name><degrees>MD, PhD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA</aff><aff id="A2"><label>2</label>Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA</aff><aff id="A3"><label>3</label>Department of Otolaryngology-Head and Neck Surgery, University of Toronto, Toronto, ON</aff><author-notes><corresp id="FN1">Corresponding Author: J. Kenneth Byrd, MD, Department of Otolaryngology, University of Pittsburgh Medical Center 200 Lothrop Street Suite 500 Pittsburgh, PA 15213, USA, Phone: 412-647-2117, Fax: 412-647-2080, <email>byrdjk@upmc.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>11</day><month>9</month><year>2014</year></pub-date><pub-date pub-type="epub"><day>11</day><month>3</month><year>2014</year></pub-date><pub-date pub-type="ppub"><month>6</month><year>2014</year></pub-date><pub-date pub-type="pmc-release"><day>11</day><month>9</month><year>2015</year></pub-date><volume>150</volume><issue>6</issue><fpage>976</fpage><lpage>982</lpage><pmc-comment>elocation-id from pubmed: 10.1177/0194599814525746</pmc-comment>
<abstract><sec id="S1"><title>Objective</title><p id="P1">To evaluate the cost-effectiveness of transoral robotic surgery (TORS) for diagnosis and treatment of cervical unknown primary squamous cell carcinoma (CUP).</p></sec><sec id="S2"><title>Study Design</title><p id="P2">Retrospective Review</p></sec><sec id="S3"><title>Subjects and Methods</title><p id="P3">A retrospective chart review was performed on patients with new occult primary squamous cell carcinoma of the head and neck with non-diagnostic imaging and/or endoscopy who were treated with TORS at a tertiary hospital between 2009 and 2012. Direct costs ($) were obtained from the hospital’s billing system, and national data were used for inpatient hospital costs and physician fees. The proportion of tumors found in three strategies was used as effectiveness to calculate the incremental cost-effectiveness ratio.</p></sec><sec id="S4"><title>Results</title><p id="P4">206 head and neck robotic cases were performed at our institution between December 2009 and December 2012. Three surgeons performed TORS on 22 patients for occult primary squamous cell carcinoma. The primary tumor was located in 19/22 (86.4%) patients. The incremental cost-effectiveness ratio for sequential and simultaneous EUA and TORS base of tongue resection was $8619 and $5774 per additional primary identified, respectively.</p></sec><sec id="S5"><title>Conclusion</title><p id="P5">TORS is a cost-effective procedure to locate the primary tumor in patients with cervical lymph node metastases and no obvious source. Bilateral base of tongue resection should be considered as part of the exam under anesthesia for these patients, particularly if the palatine tonsils have already been removed.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Amérique/explor/PittsburghV1/Data/Pmc/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001573 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd -nk 001573 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Amérique
|area= PittsburghV1
|flux= Pmc
|étape= Curation
|type= RBID
|clé= PMC:4167971
|texte= Transoral Robotic Surgery and the Unknown Primary: A Cost-Effective Technique to Identify the Tumor
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Curation/RBID.i -Sk "pubmed:24618502" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Curation/biblio.hfd \
| NlmPubMed2Wicri -a PittsburghV1
| This area was generated with Dilib version V0.6.38. |  |