Tim M Govers1, Sejal Patel1, Robert P Takes2, Thijs Merkx3, Maroeska Rovers1,4, Janneke Grutters1,4. 1. Department of Operating Rooms, Radboud University Medical Center, Nijmegen, The Netherlands. 2. Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands. 4. Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands.
Abstract
BACKGROUND: Choosing between a more or less extensive neck dissection implies a tradeoff between survival, quality of life, and costs. The purpose of this study was to determine if selective neck dissection (level I-III or I-IV) is cost-effective compared with modified radical neck dissection (level I-V) in patients with cT1-2 oral squamous cell carcinoma (OSCC) with singular nodal disease confined to level I or II. METHODS: A decision-analytic model was developed to model quality-adjusted life years (QALYs) and costs over a lifetime horizon, based on literature. RESULTS: The selective neck dissection strategy resulted in an expected health loss of 0.06 QALY and savings of €1351 per patient compared to modified radical neck dissection. The results were sensitive to differences in regional failure probabilities between the strategies. CONCLUSION: With the evidence used in this model, selective neck dissection was not cost-effective compared to modified radical neck dissection. Prospective research on regional failure is needed to provide optimal treatment for patients with OSCC.
BACKGROUND: Choosing between a more or less extensive neck dissection implies a tradeoff between survival, quality of life, and costs. The purpose of this study was to determine if selective neck dissection (level I-III or I-IV) is cost-effective compared with modified radical neck dissection (level I-V) in patients with cT1-2 oral squamous cell carcinoma (OSCC) with singular nodal disease confined to level I or II. METHODS: A decision-analytic model was developed to model quality-adjusted life years (QALYs) and costs over a lifetime horizon, based on literature. RESULTS: The selective neck dissection strategy resulted in an expected health loss of 0.06 QALY and savings of €1351 per patient compared to modified radical neck dissection. The results were sensitive to differences in regional failure probabilities between the strategies. CONCLUSION: With the evidence used in this model, selective neck dissection was not cost-effective compared to modified radical neck dissection. Prospective research on regional failure is needed to provide optimal treatment for patients with OSCC.
Authors: Egon Burian; Benjamin Palla; Nicholas Callahan; Thomas Pyka; Constantin Wolff; Claudio E von Schacky; Annabelle Schmid; Matthias F Froelich; Johannes Rübenthaler; Marcus R Makowski; Felix G Gassert Journal: Eur J Nucl Med Mol Imaging Date: 2022-05-24 Impact factor: 10.057
Authors: Mirre Scholte; Kas Woudstra; Janneke P C Grutters; Gerjon Hannink; Marcia Tummers; Rob P B Reuzel; Maroeska M Rovers Journal: BMJ Surg Interv Health Technol Date: 2022-09-02