Treatment for early endometrial cancer. Cost-effectiveness analysis
Fanning, J.
Journal of Reproductive Medicine 44(8): 719-723
1999
ISSN/ISBN: 0024-7758 PMID: 10483543 Document Number: 511566
OBJECTIVE: To evaluate the cost-effectiveness of treatment for early endometrial cancer. STUDY DESIGN: Cost-minimization type of cost-effectiveness analysis with payer costs based on CPT (physician's current procedural terminology) and DRG (disease related group) codes. The six principles of cost-effectiveness analysis were evaluated. We compared the standard treatment protocol of selected lymphadenectomy/selective teletherapy (lymphadenectomy and postoperative teletherapy administered for high-risk tumors) as performed by the majority of gynecologic oncologists vs. an alternate treatment protocol of lymphadenectomy/selective brachytherapy (lymphadenectomy for all tumors, brachytherapy for high-risk tumors and teletherapy reserved for nodal metastasis) as performed by 10-12% of gynecologic oncologists. RESULTS: In cost-minimization analysis, lymphadenectomy/selective brachytherapy was 12% less expensive than the standard treatment protocol of selective lymphadenectomy/teletherapy. CONCLUSION: Although only 10-12% of gynecologic oncologists perform lymphadenectomy on all patients, deliver brachytherapy for high-risk tumors and reserve teletherapy for lymph node metastasis, it is a cost-effective treatment strategy for early endometrial cancer.