Danalyn Byng, Michael Schaapveld, Esther H Lips, Frederieke H van Duijnhoven, Jelle Wesseling, Wim H van Harten, Valesca P Retèl
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引用次数: 0
Abstract
Aim: Perform early economic evaluation comparing active surveillance (AS) to surgery for women with low-risk ductal carcinoma in situ, a precursor of invasive breast cancer.Materials & methods: A 10-year incremental costs (€) and quality-adjusted life years (QALYs) were compared between a simulated cohort of women undergoing breast conserving surgery ± radiotherapy, and a cohort with a low-risk subgroup undergoing AS using a semi-Markov model. Scenario and headroom analyses evaluated a better-performing biomarker to select low-risk women for AS.Results: AS resulted in lower costs and survival, but higher QALYs (±0.40). Scenario analyses maintained survival outcomes and maximized QALYs.Conclusion: AS for low-risk ductal carcinoma in situ is cost-effective, but a better-performing biomarker to select low-risk women can maximize quality-adjusted outcomes.
目的：对患有低风险导管原位癌（浸润性乳腺癌的前兆）的妇女进行早期经济评估，比较主动监测（AS）和手术治疗：采用半马尔可夫模型，比较了接受保乳手术和放疗的模拟组群与接受主动监测的低风险亚组的 10 年增量成本（欧元）和质量调整生命年（QALYs）。情景分析和余量分析评估了一种性能更好的生物标志物，用于选择低风险妇女接受人工乳房切除术：强直性脊柱炎降低了成本和生存率，但提高了QALY（±0.40）。情景分析维持了生存结果，并最大限度地提高了QALY：低风险导管原位癌的 AS 具有成本效益，但用性能更好的生物标志物来选择低风险妇女可最大限度地提高质量调整结果。
期刊介绍：
Future Oncology (ISSN 1479-6694) provides a forum for a new era of cancer care. The journal focuses on the most important advances and highlights their relevance in the clinical setting. Furthermore, Future Oncology delivers essential information in concise, at-a-glance article formats - vital in delivering information to an increasingly time-constrained community.
The journal takes a forward-looking stance toward the scientific and clinical issues, together with the economic and policy issues that confront us in this new era of cancer care. The journal includes literature awareness such as the latest developments in radiotherapy and immunotherapy, concise commentary and analysis, and full review articles all of which provide key findings, translational to the clinical setting.
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