Positron emission tomography/computed tomography introduction in the clinical management of patients with suspected recurrence of ovarian cancer: a cost-effectiveness analysis |
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Authors: | M. MANSUETO, msc,A. GRIMALDI, msc,G. MANGILI, md,M. PICCHIO, md,G. GIOVACCHINI, md,R. VIGANÒ , md,C. MESSA, md,& F. FAZIO, md |
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Affiliation: | Institute for Bioimaging and Molecular Physiology, National Research Council, University of Milano-Bicocca and San Raffaele Hospital Scientific Institute, Milan, Italy; Gynecological Department, Scientific Institute San Raffaele, Milan;
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Abstract: | Aim of this study was to evaluate the economic impact of the introduction of positron emission tomography/computed tomography (PET/CT) in the early detection of recurrent ovarian cancer through a cost-effectiveness analysis of different diagnostic strategies. Thirty-two consecutive patients with suspected ovarian cancer recurrence, studied by both contrast enhanced abdominal CT and PET/CT, were retrospectively included in the study. Three different diagnostic strategies were evaluated and compared: (1) CT only or baseline strategy; (2) PET/CT for negative CT or strategy A; (3) PET/CT for All or strategy B. For each one, expected costs, avoided surgery and incremental cost-effectiveness ratio (ICER) were calculated to identify the most cost-effective strategy. The number of positive patients increased from baseline strategy (20/32) to strategy A and B (30/32 and 29/32 respectively). Positron emission tomography/computed tomography reoriented physician choice in 31% and 62% of patients (strategies A and B respectively). Strategy A is dominated by strategy B, which is more expensive (2909€ vs. 2958€), but also more effective (3 cases of surgery avoided) and presents an ICER of 226.77€ per surgery avoided (range: 49.50–433.00€). Positron emission tomography/computed tomography introduction in this population is cost-effective and allowed to redirect the clinical management of patients towards more appropriate therapeutic choices. |
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Keywords: | ovarian cancer PET/CT cost analysis cost-effectiveness |
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