Is selective lymphadenectomy more cost-effective than routine lymphadenectomy in patients with endometrial cancer?
Identifieur interne : 001E98 ( PubMed/Curation ); précédent : 001E97; suivant : 001E99Is selective lymphadenectomy more cost-effective than routine lymphadenectomy in patients with endometrial cancer?
Auteurs : A E Clements [États-Unis] ; B J Tierney ; D E Cohn ; J M StraughnSource :
- Gynecologic oncology [ 1095-6859 ] ; 2013.
Descripteurs français
- KwdFr :
- Analyse coût-bénéfice, Facteurs de risque, Femelle, Humains, Lymphadénectomie (), Lymphadénectomie (économie), Métastase lymphatique, Noeuds lymphatiques (), Noeuds lymphatiques (anatomopathologie), Stade de la tumeur, Techniques d'aide à la décision, Tumeurs de l'endomètre (), Tumeurs de l'endomètre (anatomopathologie), Tumeurs de l'endomètre (économie), États-Unis d'Amérique.
- MESH :
- anatomopathologie : Noeuds lymphatiques, Tumeurs de l'endomètre.
- économie : Lymphadénectomie, Tumeurs de l'endomètre.
- Analyse coût-bénéfice, Facteurs de risque, Femelle, Humains, Lymphadénectomie, Métastase lymphatique, Noeuds lymphatiques, Stade de la tumeur, Techniques d'aide à la décision, Tumeurs de l'endomètre, États-Unis d'Amérique.
- Wicri :
- geographic : États-Unis.
English descriptors
- KwdEn :
- Cost-Benefit Analysis, Decision Support Techniques, Endometrial Neoplasms (economics), Endometrial Neoplasms (pathology), Endometrial Neoplasms (surgery), Female, Humans, Lymph Node Excision (economics), Lymph Node Excision (methods), Lymph Nodes (pathology), Lymph Nodes (surgery), Lymphatic Metastasis, Neoplasm Staging, Risk Factors, United States.
- MESH :
- geographic : United States.
- economics : Endometrial Neoplasms, Lymph Node Excision.
- methods : Lymph Node Excision.
- pathology : Endometrial Neoplasms, Lymph Nodes.
- surgery : Endometrial Neoplasms, Lymph Nodes.
- Cost-Benefit Analysis, Decision Support Techniques, Female, Humans, Lymphatic Metastasis, Neoplasm Staging, Risk Factors.
Abstract
The objective of this study is to determine the cost-effectiveness of two strategies in women undergoing surgery for newly diagnosed endometrial cancer.
DOI: 10.1016/j.ygyno.2012.10.007
PubMed: 23078763
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last="Cohn">D E Cohn</name></author><author><name sortKey="Straughn, J M" sort="Straughn, J M" uniqKey="Straughn J" first="J M" last="Straughn">J M Straughn</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2013">2013</date><idno type="RBID">pubmed:23078763</idno><idno type="pmid">23078763</idno><idno type="doi">10.1016/j.ygyno.2012.10.007</idno><idno type="wicri:Area/PubMed/Corpus">001E98</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">001E98</idno><idno type="wicri:Area/PubMed/Curation">001E98</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">001E98</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Is selective lymphadenectomy more cost-effective than routine lymphadenectomy in patients with endometrial cancer?</title><author><name sortKey="Clements, A E" sort="Clements, A E" uniqKey="Clements A" first="A E" last="Clements">A E Clements</name><affiliation wicri:level="1"><nlm:affiliation>Divisions of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA. aine.clements@osumc.edu</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Divisions of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH</wicri:regionArea></affiliation></author><author><name sortKey="Tierney, B J" sort="Tierney, B J" uniqKey="Tierney B" first="B J" last="Tierney">B J Tierney</name></author><author><name sortKey="Cohn, D E" sort="Cohn, D E" uniqKey="Cohn D" first="D E" last="Cohn">D E Cohn</name></author><author><name sortKey="Straughn, J M" sort="Straughn, J M" uniqKey="Straughn J" first="J M" last="Straughn">J M Straughn</name></author></analytic><series><title level="j">Gynecologic oncology</title><idno type="eISSN">1095-6859</idno><imprint><date when="2013" 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(anatomopathologie)</term><term>Stade de la tumeur</term><term>Techniques d'aide à la décision</term><term>Tumeurs de l'endomètre ()</term><term>Tumeurs de l'endomètre (anatomopathologie)</term><term>Tumeurs de l'endomètre (économie)</term><term>États-Unis d'Amérique</term></keywords><keywords scheme="MESH" type="geographic" xml:lang="en"><term>United States</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Noeuds lymphatiques</term><term>Tumeurs de l'endomètre</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Endometrial Neoplasms</term><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Lymph Node Excision</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Endometrial Neoplasms</term><term>Lymph Nodes</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Endometrial Neoplasms</term><term>Lymph Nodes</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Lymphadénectomie</term><term>Tumeurs de l'endomètre</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Cost-Benefit Analysis</term><term>Decision Support Techniques</term><term>Female</term><term>Humans</term><term>Lymphatic Metastasis</term><term>Neoplasm Staging</term><term>Risk Factors</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Analyse coût-bénéfice</term><term>Facteurs de risque</term><term>Femelle</term><term>Humains</term><term>Lymphadénectomie</term><term>Métastase lymphatique</term><term>Noeuds lymphatiques</term><term>Stade de la tumeur</term><term>Techniques d'aide à la décision</term><term>Tumeurs de l'endomètre</term><term>États-Unis d'Amérique</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>États-Unis</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The objective of this study is to determine the cost-effectiveness of two strategies in women undergoing surgery for newly diagnosed endometrial cancer.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">23078763</PMID><DateCreated><Year>2013</Year><Month>01</Month><Day>22</Day></DateCreated><DateCompleted><Year>2013</Year><Month>03</Month><Day>25</Day></DateCompleted><DateRevised><Year>2013</Year><Month>01</Month><Day>22</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1095-6859</ISSN><JournalIssue CitedMedium="Internet"><Volume>128</Volume><Issue>2</Issue><PubDate><Year>2013</Year><Month>Feb</Month></PubDate></JournalIssue><Title>Gynecologic oncology</Title><ISOAbbreviation>Gynecol. Oncol.</ISOAbbreviation></Journal><ArticleTitle>Is selective lymphadenectomy more cost-effective than routine lymphadenectomy in patients with endometrial cancer?</ArticleTitle><Pagination><MedlinePgn>166-70</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.ygyno.2012.10.007</ELocationID><ELocationID EIdType="pii" ValidYN="Y">S0090-8258(12)00809-8</ELocationID><Abstract><AbstractText Label="OBJECTIVE" NlmCategory="OBJECTIVE">The objective of this study is to determine the cost-effectiveness of two strategies in women undergoing surgery for newly diagnosed endometrial cancer.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A decision analysis model compared two surgical strategies: 1) routine lymphadenectomy independent of intraoperative risk factors or 2) selective lymphadenectomy for women with high or intermediate risk tumors based on intraoperative assessment including tumor grade, depth of invasion, and tumor size. Published data were used to estimate the outcomes of stage, adjuvant therapy, and recurrence. Costs of surgery, radiation, and chemotherapy were estimated using Medicare Current Procedural Technology codes and Physician Fee Schedule. Cost-effectiveness ratios were estimated for each strategy. Sensitivity analyses were performed including an estimate for lymphedema for patients that underwent a lymphadenectomy.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">For 40,000 women diagnosed annually with endometrial cancer in the United States, the annual cost of selective lymphadenectomy is $1.14 billion compared to $1.02 billion for routine lymphadenectomy. The selective lymphadenectomy strategy cost an additional $123.3 million. Five-year progression-free survival was 85.9% in the routine strategy compared to 79.3% in the selective strategy. Treatment cost $6349 more per survivor in the selective strategy compared to routine strategy ($36,078 vs. $29,729). These results held up under a variety of sensitivity analyses including costs due to lymphedema which were higher in the routine lymphadenectomy strategy compared to the selective lymphadenectomy strategy ($10 million vs. $7.75 million).</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">A strategy of selective lymphadenectomy based on intraoperative risk factors for patients with endometrial cancer was less cost-effective than routine lymphadenectomy even when the impact of lymphedema was considered.</AbstractText><CopyrightInformation>Copyright © 2012 Elsevier Inc. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Clements</LastName><ForeName>A E</ForeName><Initials>AE</Initials><AffiliationInfo><Affiliation>Divisions of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH, USA. aine.clements@osumc.edu</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tierney</LastName><ForeName>B J</ForeName><Initials>BJ</Initials></Author><Author ValidYN="Y"><LastName>Cohn</LastName><ForeName>D E</ForeName><Initials>DE</Initials></Author><Author ValidYN="Y"><LastName>Straughn</LastName><ForeName>J M</ForeName><Initials>JM</Initials><Suffix>Jr</Suffix></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2012</Year><Month>10</Month><Day>16</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Gynecol Oncol</MedlineTA><NlmUniqueID>0365304</NlmUniqueID><ISSNLinking>0090-8258</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D003362" MajorTopicYN="N">Cost-Benefit Analysis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003661" MajorTopicYN="N">Decision Support Techniques</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016889" MajorTopicYN="N">Endometrial Neoplasms</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008197" MajorTopicYN="N">Lymph Node Excision</DescriptorName><QualifierName UI="Q000191" MajorTopicYN="Y">economics</QualifierName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008198" MajorTopicYN="N">Lymph Nodes</DescriptorName><QualifierName UI="Q000473" MajorTopicYN="N">pathology</QualifierName><QualifierName UI="Q000601" MajorTopicYN="Y">surgery</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008207" MajorTopicYN="N">Lymphatic Metastasis</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009367" MajorTopicYN="N">Neoplasm Staging</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D014481" MajorTopicYN="N" Type="Geographic">United States</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2012</Year><Month>06</Month><Day>19</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2012</Year><Month>10</Month><Day>02</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2012</Year><Month>10</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2012</Year><Month>10</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2012</Year><Month>10</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2013</Year><Month>3</Month><Day>26</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">23078763</ArticleId><ArticleId IdType="pii">S0090-8258(12)00809-8</ArticleId><ArticleId IdType="doi">10.1016/j.ygyno.2012.10.007</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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