Abstract
Currently, up to 50% of the operations in early-stage non-small cell lung cancer (NSCLC) are futile owing to the presence of locally advanced tumour or distant metastases. More accurate pre-operative staging is required in order to reduce the number of futile operations. The cost-effectiveness of fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}FDG-PET) added to the conventional diagnostic work-up was studied in the PLUS study. Prior to invasive staging and/or thoracotomy, 188 patients with (suspected) NSCLC were randomly assigned to conventional work-up (CWU) and whole-body PET or to CWU alone. CWU was based on prevailing guidelines. Pre-operative staging was followed by 1 year of follow-up. Outcomes are expressed in the percentage of correctly staged patients and the associated costs. The cost price of PET varied between and euro;736 and and euro;1,588 depending on the (hospital) setting and the procurement of {sup 18}FDG commercially or from on-site production. In the CWU group, 41% of the patients underwent a futile thoracotomy, whereas in the PET group 21% of the thoracotomies were considered futile (P=0.003). The average costs per patient in the CWU group were and euro;9,573 and in the PET group, and euro;8,284. The major cost driver was the number of hospital days
More>>
Verboom, Paul;
Grijseels, E W M;
Uyl-de Groot, Carin A;
[1]
Tinteren, Harm van;
Diepenhorst, Fred W;
[2]
Hoekstra, Otto S;
[3]
Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)];
Smit, Egbert F;
Postmus, Pieter E;
[4]
Bergh, Jan H.A.M. van den;
Velthoven, Piet C.M. van;
[5]
Schreurs, Ad J.M.;
[6]
Stallaert, Roland A.L.M.;
[7]
Comans, Emile F.I.;
Teule, Gerrit J.J.;
[3]
Mourik, Johan C. van;
[8]
Boers, Maarten
[9]
- Institute for Medical Technology Assessment, Erasmus Medical Centre/Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam (Netherlands)
- Comprehensive Cancer Centre Amsterdam (Netherlands)
- Department of Nuclear Medicine, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)
- Department of Pulmonology, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)
- Department of Pulmonology, Medical Centre Alkmaar (Netherlands)
- Department of Pulmonology, Onze Lieve Vrouwe Gasthuis, Amsterdam (Netherlands)
- Department of Pulmonology, Westfries Gasthuis (Netherlands)
- Department of Surgery, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)
- Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)
Citation Formats
Verboom, Paul, Grijseels, E W M, Uyl-de Groot, Carin A, Tinteren, Harm van, Diepenhorst, Fred W, Hoekstra, Otto S, Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)], Smit, Egbert F, Postmus, Pieter E, Bergh, Jan H.A.M. van den, Velthoven, Piet C.M. van, Schreurs, Ad J.M., Stallaert, Roland A.L.M., Comans, Emile F.I., Teule, Gerrit J.J., Mourik, Johan C. van, and Boers, Maarten.
Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: the PLUS study.
Germany: N. p.,
2003.
Web.
doi:10.1007/s00259-003-1199-9.
Verboom, Paul, Grijseels, E W M, Uyl-de Groot, Carin A, Tinteren, Harm van, Diepenhorst, Fred W, Hoekstra, Otto S, Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)], Smit, Egbert F, Postmus, Pieter E, Bergh, Jan H.A.M. van den, Velthoven, Piet C.M. van, Schreurs, Ad J.M., Stallaert, Roland A.L.M., Comans, Emile F.I., Teule, Gerrit J.J., Mourik, Johan C. van, & Boers, Maarten.
Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: the PLUS study.
Germany.
https://doi.org/10.1007/s00259-003-1199-9
Verboom, Paul, Grijseels, E W M, Uyl-de Groot, Carin A, Tinteren, Harm van, Diepenhorst, Fred W, Hoekstra, Otto S, Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)], Smit, Egbert F, Postmus, Pieter E, Bergh, Jan H.A.M. van den, Velthoven, Piet C.M. van, Schreurs, Ad J.M., Stallaert, Roland A.L.M., Comans, Emile F.I., Teule, Gerrit J.J., Mourik, Johan C. van, and Boers, Maarten.
2003.
"Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: the PLUS study."
Germany.
https://doi.org/10.1007/s00259-003-1199-9.
@misc{etde_20407690,
title = {Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: the PLUS study}
author = {Verboom, Paul, Grijseels, E W M, Uyl-de Groot, Carin A, Tinteren, Harm van, Diepenhorst, Fred W, Hoekstra, Otto S, Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)], Smit, Egbert F, Postmus, Pieter E, Bergh, Jan H.A.M. van den, Velthoven, Piet C.M. van, Schreurs, Ad J.M., Stallaert, Roland A.L.M., Comans, Emile F.I., Teule, Gerrit J.J., Mourik, Johan C. van, and Boers, Maarten}
abstractNote = {Currently, up to 50% of the operations in early-stage non-small cell lung cancer (NSCLC) are futile owing to the presence of locally advanced tumour or distant metastases. More accurate pre-operative staging is required in order to reduce the number of futile operations. The cost-effectiveness of fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}FDG-PET) added to the conventional diagnostic work-up was studied in the PLUS study. Prior to invasive staging and/or thoracotomy, 188 patients with (suspected) NSCLC were randomly assigned to conventional work-up (CWU) and whole-body PET or to CWU alone. CWU was based on prevailing guidelines. Pre-operative staging was followed by 1 year of follow-up. Outcomes are expressed in the percentage of correctly staged patients and the associated costs. The cost price of PET varied between and euro;736 and and euro;1,588 depending on the (hospital) setting and the procurement of {sup 18}FDG commercially or from on-site production. In the CWU group, 41% of the patients underwent a futile thoracotomy, whereas in the PET group 21% of the thoracotomies were considered futile (P=0.003). The average costs per patient in the CWU group were and euro;9,573 and in the PET group, and euro;8,284. The major cost driver was the number of hospital days related to recovery from surgery. Sensitivity analysis on the cost and accuracy of PET showed that the results were robust, i.e. in favour of the PET group. The addition of PET to CWU prevented futile surgery in one out of five patients with suspected NSCLC. Despite the additional PET costs, the total costs were lower in the PET group, mainly due to a reduction in the number of futile operations. The additional use of PET in the staging of patients with NSCLC is feasible, safe and cost saving from a clinical and from an economic perspective. (orig.)}
doi = {10.1007/s00259-003-1199-9}
journal = []
issue = {11}
volume = {30}
journal type = {AC}
place = {Germany}
year = {2003}
month = {Nov}
}
title = {Cost-effectiveness of FDG-PET in staging non-small cell lung cancer: the PLUS study}
author = {Verboom, Paul, Grijseels, E W M, Uyl-de Groot, Carin A, Tinteren, Harm van, Diepenhorst, Fred W, Hoekstra, Otto S, Department of Clinical Epidemiology and Biostatistics, Vrije Universiteit Medical Centre, Amsterdam (Netherlands)], Smit, Egbert F, Postmus, Pieter E, Bergh, Jan H.A.M. van den, Velthoven, Piet C.M. van, Schreurs, Ad J.M., Stallaert, Roland A.L.M., Comans, Emile F.I., Teule, Gerrit J.J., Mourik, Johan C. van, and Boers, Maarten}
abstractNote = {Currently, up to 50% of the operations in early-stage non-small cell lung cancer (NSCLC) are futile owing to the presence of locally advanced tumour or distant metastases. More accurate pre-operative staging is required in order to reduce the number of futile operations. The cost-effectiveness of fluorine-18 fluorodeoxyglucose positron emission tomography ({sup 18}FDG-PET) added to the conventional diagnostic work-up was studied in the PLUS study. Prior to invasive staging and/or thoracotomy, 188 patients with (suspected) NSCLC were randomly assigned to conventional work-up (CWU) and whole-body PET or to CWU alone. CWU was based on prevailing guidelines. Pre-operative staging was followed by 1 year of follow-up. Outcomes are expressed in the percentage of correctly staged patients and the associated costs. The cost price of PET varied between and euro;736 and and euro;1,588 depending on the (hospital) setting and the procurement of {sup 18}FDG commercially or from on-site production. In the CWU group, 41% of the patients underwent a futile thoracotomy, whereas in the PET group 21% of the thoracotomies were considered futile (P=0.003). The average costs per patient in the CWU group were and euro;9,573 and in the PET group, and euro;8,284. The major cost driver was the number of hospital days related to recovery from surgery. Sensitivity analysis on the cost and accuracy of PET showed that the results were robust, i.e. in favour of the PET group. The addition of PET to CWU prevented futile surgery in one out of five patients with suspected NSCLC. Despite the additional PET costs, the total costs were lower in the PET group, mainly due to a reduction in the number of futile operations. The additional use of PET in the staging of patients with NSCLC is feasible, safe and cost saving from a clinical and from an economic perspective. (orig.)}
doi = {10.1007/s00259-003-1199-9}
journal = []
issue = {11}
volume = {30}
journal type = {AC}
place = {Germany}
year = {2003}
month = {Nov}
}