FRINK Linked Data Fragments server

Matches in SemOpenAlex for { <https://semopenalex.org/work/W2000811008> ?p ?o ?g. }

• W2000811008 endingPage "S89" @default.
• W2000811008 startingPage "S89" @default.
• W2000811008 abstract "Patients with node-positive head-and-neck squamous cell carcinomas (HNC) have a significant risk of residual disease (RD) in the neck after treatment, despite optimal chemoradiotherapy (CRT). Adjuvant neck dissection (ND) after CRT has been considered standard treatment, but its morbidity has led investigators to consider using post-CRT, CT, and positron emission tomography (PET-CT) to determine the need for surgery. We investigated the cost-effectiveness of these modalities as predictors of the need for ND compared with ND for all patients. We developed a Markov model to describe health states in the 5 years after CRT for HNC in a 50-year-old man. We compared three strategies: dissect all patients (DA), dissect patients with RD on CT, and dissect patients with RD on PET-CT. Recurrence risks, costs, and utilities were adapted from the literature. Probabilistic sensitivity analyses were performed to model uncertainty in PET-CT performance, patient utilities for up-front and salvage dissection health states, and upfront and salvage dissection costs. The model predicted 5-year disease-free and locoregional recurrence-free survival rates of 49% and 69%, consistent with results from RTOG 99-14 (48.5% and 64% at 4 years). Neck dissection only for patients with RD on PET-CT was the dominant strategy over a wide range of realistic and exaggerated disease, utility, and cost assumptions. Probabilistic sensitivity analyses confirmed that the PET-CT strategy was almost certainly cost-effective at a societal willingness-to-pay (WTP) threshold of $500,000/quality-adjusted life year. For example, despite varying the PET-CT sensitivity and specificity from 88–98% and 76–86%, respectively, PET-CT was always cost-effective at this WTP threshold. Even when the utilities for the dissection and no dissection health states were equal and the salvage dissection health state was varied to as low as 0.6, PET-CT was always cost-effective. The costs of salvage and immediate dissections were increased to $30,000 and lowered to $3,000, respectively, but the incremental cost-effectiveness ratio of the PET-CT strategy was less than the societal WTP in over 95% of all trials. Adjuvant neck dissection reserved for patients with residual disease on PET-CT is clearly cost-effective and, in fact, the dominant clinical pathway. The avoidance of routine dissection by this approach dramatically reduced total costs while improving the quality-of-life in the majority of patients, which are benefits not overcome by the small increase in recurrence." @default.
• W2000811008 created "2016-06-24" @default.
• W2000811008 creator A5011724315 @default.
• W2000811008 creator A5046829739 @default.
• W2000811008 creator A5073305219 @default.
• W2000811008 creator A5073653003 @default.
• W2000811008 date "2009-11-01" @default.
• W2000811008 modified "2023-09-25" @default.
• W2000811008 title "Cost-effectiveness of CT and PET-CT for Determining the Need for Adjuvant Neck Dissection in Locally Advanced Head and Neck Cancer" @default.
• W2000811008 doi "https://doi.org/10.1016/j.ijrobp.2009.07.219" @default.
• W2000811008 hasPublicationYear "2009" @default.
• W2000811008 type Work @default.
• W2000811008 sameAs 2000811008 @default.
• W2000811008 citedByCount "0" @default.
• W2000811008 crossrefType "journal-article" @default.
• W2000811008 hasAuthorship W2000811008A5011724315 @default.
• W2000811008 hasAuthorship W2000811008A5046829739 @default.
• W2000811008 hasAuthorship W2000811008A5073305219 @default.
• W2000811008 hasAuthorship W2000811008A5073653003 @default.
• W2000811008 hasBestOaLocation W20008110081 @default.
• W2000811008 hasConcept C121608353 @default.
• W2000811008 hasConcept C126322002 @default.
• W2000811008 hasConcept C126838900 @default.
• W2000811008 hasConcept C127077266 @default.
• W2000811008 hasConcept C141071460 @default.
• W2000811008 hasConcept C2775842073 @default.
• W2000811008 hasConcept C2775862295 @default.
• W2000811008 hasConcept C2776530083 @default.
• W2000811008 hasConcept C2776833033 @default.
• W2000811008 hasConcept C2778424827 @default.
• W2000811008 hasConcept C2778474501 @default.
• W2000811008 hasConcept C2780849966 @default.
• W2000811008 hasConcept C509974204 @default.
• W2000811008 hasConcept C71924100 @default.
• W2000811008 hasConceptScore W2000811008C121608353 @default.
• W2000811008 hasConceptScore W2000811008C126322002 @default.
• W2000811008 hasConceptScore W2000811008C126838900 @default.
• W2000811008 hasConceptScore W2000811008C127077266 @default.
• W2000811008 hasConceptScore W2000811008C141071460 @default.
• W2000811008 hasConceptScore W2000811008C2775842073 @default.
• W2000811008 hasConceptScore W2000811008C2775862295 @default.
• W2000811008 hasConceptScore W2000811008C2776530083 @default.
• W2000811008 hasConceptScore W2000811008C2776833033 @default.
• W2000811008 hasConceptScore W2000811008C2778424827 @default.
• W2000811008 hasConceptScore W2000811008C2778474501 @default.
• W2000811008 hasConceptScore W2000811008C2780849966 @default.
• W2000811008 hasConceptScore W2000811008C509974204 @default.
• W2000811008 hasConceptScore W2000811008C71924100 @default.
• W2000811008 hasIssue "3" @default.
• W2000811008 hasLocation W20008110081 @default.
• W2000811008 hasOpenAccess W2000811008 @default.
• W2000811008 hasPrimaryLocation W20008110081 @default.
• W2000811008 hasRelatedWork W1545130884 @default.
• W2000811008 hasRelatedWork W164411646 @default.
• W2000811008 hasRelatedWork W2000811008 @default.
• W2000811008 hasRelatedWork W2029344511 @default.
• W2000811008 hasRelatedWork W2073433816 @default.
• W2000811008 hasRelatedWork W2107892875 @default.
• W2000811008 hasRelatedWork W2111675738 @default.
• W2000811008 hasRelatedWork W2151309798 @default.
• W2000811008 hasRelatedWork W2740803122 @default.
• W2000811008 hasRelatedWork W4243680863 @default.
• W2000811008 hasVolume "75" @default.
• W2000811008 isParatext "false" @default.
• W2000811008 isRetracted "false" @default.
• W2000811008 magId "2000811008" @default.
• W2000811008 workType "article" @default.