ScholarLink (思领科)
错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of 18FFDG-PET/CT and Laparoscopy in Staging of Locally Advanced Gastric Cancer: A Cost Analysis in the Prospective Multicenter PLASTIC-Study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2024年3月25日

查看全文
  • Cas de Jongh,
  • Miriam P. van der Meulen,
  • Emma C. Gertsen,
  • Hylke J. F. Brenkman,
  • Johanna W. van Sandick,
  • Mark I. van Berge Henegouwen,
  • Suzanne S. Gisbertz,
  • Misha D. P. Luyer,
  • Grard A. P. Nieuwenhuijzen,
  • Jan J. B. van Lanschot,
  • Sjoerd M. Lagarde,
  • Bas P. L. Wijnhoven,
  • Wobbe O. de Steur,
  • Henk H. Hartgrink,
  • Jan H. M. B. Stoot,
  • Karel W. E. Hulsewe,
  • Ernst Jan Spillenaar Bilgen,
  • Marc J. van Det,
  • Ewout A. Kouwenhoven,
  • Freek Daams,
  • Donald L. van der Peet,
  • Nicole C. T. van Grieken,
  • Joos Heisterkamp,
  • Boudewijn van Etten,
  • Jan-Willem van den Berg,
  • Jean-Pierre Pierie,
  • Hasan H. Eker,
  • Annemieke Y. Thijssen,
  • Eric J. T. Belt,
  • Peter van Duijvendijk,
  • Eelco Wassenaar,
  • Kevin P. Wevers,
  • Lieke Hol,
  • Frank J. Wessels,
  • Nadia Haj Mohammad,
  • Geert W. J. Frederix,
  • Richard van Hillegersberg,
  • Peter D. Siersema,
  • Erik Vegt,
  • Jelle P. Ruurda

摘要

Background

Unnecessary D2-gastrectomy and associated costs can be prevented after detecting non-curable gastric cancer, but impact of staging on treatment costs is unclear. This study determined the cost impact of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FFDG-PET/CT) and staging laparoscopy (SL) in gastric cancer staging.

Materials and Methods

In this cost analysis, four staging strategies were modeled in a decision tree: (1) 18FFDG-PET/CT first, then SL, (2) SL only, (3) 18FFDG-PET/CT only, and (4) neither SL nor 18FFDG-PET/CT. Costs were assessed on the basis of the prospective PLASTIC-study, which evaluated adding 18FFDG-PET/CT and SL to staging advanced gastric cancer (cT3–4 and/or cN+) in 18 Dutch hospitals. The Dutch Healthcare Authority provided 18FFDG-PET/CT unit costs. SL unit costs were calculated bottom-up. Gastrectomy-associated costs were collected with hospital claim data until 30 days postoperatively. Uncertainty was assessed in a probabilistic sensitivity analysis (1000 iterations).

Results

18FFDG-PET/CT costs were €1104 including biopsy/cytology. Bottom-up calculations totaled €1537 per SL. D2-gastrectomy costs were €19,308. Total costs per patient were €18,137 for strategy 1, €17,079 for strategy 2, and €19,805 for strategy 3. If all patients undergo gastrectomy, total costs were €18,959 per patient (strategy 4). Performing SL only reduced costs by €1880 per patient. Adding 18FFDG-PET/CT to SL increased costs by €1058 per patient; IQR €870–1253 in the sensitivity analysis.

Conclusions

For advanced gastric cancer, performing SL resulted in substantial cost savings by reducing unnecessary gastrectomies. In contrast, routine 18FFDG-PET/CT increased costs without substantially reducing unnecessary gastrectomies, and is not recommended due to limited impact with major costs.

Trial registration: NCT03208621. This trial was registered prospectively on 30-06-2017.