HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cohn, D. E. Articles by Straughn, J. M. Search for Related Content PubMed PubMed Citation Articles by Cohn, D. E. Articles by Straughn, J. M., Jr Related Collections Gynecologic oncology Cost effective analysis

Cost-Effectiveness Analysis of Strategies for the Surgical Management of Grade 1 Endometrial Adenocarcinoma

From the ¹Division of Gynecologic Oncology, Ohio State University College of Medicine, Columbus, Ohio; and ²Division of Gynecologic Oncology, University of Alabama at Birmingham, Birmingham, Alabama.

OBJECTIVE: To estimate the costs and outcomes of various strategies used for the management of grade 1 endometrial cancer.

METHODS: A cost-effectiveness analysis compared three strategies for the management of grade 1 endometrial cancer: 1) surgical staging in all patients (including hysterectomy and lymphadenectomy); 2) frozen section following hysterectomy with surgical staging based on the results of tumor grade and depth of myometrial invasion; and 3) hysterectomy without surgical staging (no staging). Surgical probabilities and recurrence rates were estimated from published data. Actual payer costs of surgery, radiation therapy, and chemotherapy were estimated for each strategy. Cost-effectiveness ratios were estimated for each strategy. Sensitivity analyses evaluated the costs of radiation and survival estimates used in the model.

RESULTS: For the estimated 10,000 women diagnosed annually with grade 1 endometrial cancer in the United States, the annual cost of surgical staging is $240.4 million, compared with $252.4 million for frozen section and $255.8 million for no staging. Five-year disease-free survival for surgical staging is 87.9%, compared with 87.3% for frozen section and 86.7% for no staging. This translates into a lower cost-effectiveness ratio for surgical staging ($27,337) compared with frozen section ($28,913) or no staging ($29,513). Surgical staging yielded 64 additional disease-free patients per 10,000 patients compared with frozen section and 126 additional disease-free patients compared with no staging. Use of adjuvant radiation therapy was the lowest in the surgical staging strategy (13%).

CONCLUSION: Surgical staging of all patients with grade 1 endometrial cancer is the most cost-effective strategy and decreases the use of radiation therapy without negatively impacting survival.

This article has been cited by other articles:

				J. Kwon, M. Carey, S. Goldie, and J. Kim Cost-Effectiveness Analysis of Strategies for the Surgical Management of Grade 1 Endometrial Adenocarcinoma Obstet. Gynecol., October 1, 2007; 110(4): 933 - 933. [Full Text] [PDF]

				D. E. Cohn, J. M. Fowler, W. K. Huh, and J. M. Straughn Jr Cost-Effectiveness Analysis of Strategies for the Surgical Management of Grade 1 Endometrial Adenocarcinoma Obstet. Gynecol., October 1, 2007; 110(4): 933 - 934. [Full Text] [PDF]