Document Detail


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.
MedLine Citation:
PMID:  22252963     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVES/HYPOTHESIS: To study the cost effectiveness of positron emission tomography-computerized tomography (PET-CT) scanning in the management of the neck after chemoradiotherapy (CRT). STUDY DESIGN: Cost effectiveness and decision analysis model. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors:
Amy Rabalais; Rohan R Walvekar; Jonas T Johnson; Kenneth J Smith
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-1-17
Journal Detail:
Title:  The Laryngoscope     Volume:  -     ISSN:  1531-4995     ISO Abbreviation:  -     Publication Date:  2012 Jan 
Date Detail:
Created Date:  2012-1-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Affiliation:
Department of Otolaryngology-Head and Neck Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana.
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