The Role of Surgical Resection in Stage IIIA Non-Small Cell Lung Cancer: A Decision and Cost-Effectiveness Analysis
作者： Pamela Samson , Aalok Patel , Cliff G. Robinson , Daniel Morgensztern , Su-Hsin Chang
DOI: 10.1016/J.ATHORACSUR.2015.05.091
关键词: Medicine 、 Retrospective cohort study 、 Propensity score matching 、 Combination chemotherapy 、 Pneumonectomy 、 Radiation therapy 、 Cost-effectiveness analysis 、 Surgery 、 Mortality rate 、 Chemotherapy
摘要: Background This study evaluated the cost-effectiveness of combination chemotherapy, radiotherapy, and surgical intervention (CRS) vs definitive chemotherapy radiotherapy (CR) in clinical stage IIIA non-small cell lung cancer (NSCLC) patients at academic nonacademic centers. Methods Patients with NSCLC receiving CR or CRS from 1998 to 2010 were identified National Cancer Data Base. Propensity score matching on patient, tumor, treatment characteristics was performed. Medicare allowable charges used for costs. The incremental ratio (ICER) based probabilistic 5-year survival calculated as cost per life-year gained. Results We 5,265 matched patient pairs. Surgical resection imparted an increased effectiveness 0.83 life-years, ICER $17,618. Among centers, 1,634 demonstrated a benefit 0.86 life-years gained, $17,124. At 3,201 had 0.81 resection, $18,144. Finally, 3,713 between Academic center 1.5 months gained dominated model lower estimates associated 30-day mortality rates. Conclusions In NSCLC, selective addition is cost-effective compared chemoradiation therapy These conclusions are valid over range clinically meaningful variations outcomes.
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Daniel Morgensztern, Saiama Waqar, Janakiraman Subramanian, Feng Gao, Kathryn Trinkaus, Ramaswamy Govindan, Prognostic Significance of Tumor Size in Patients with Stage III Non–Small-Cell Lung Cancer: A Surveillance, Epidemiology, and End Results (SEER) Survey from 1998 to 2003 Journal of Thoracic Oncology. ,vol. 7, pp. 1479- 1484 ,(2012) , 10.1097/JTO.0B013E318267D032
David W Johnstone, Roger W Byhardt, David Ettinger, Charles B Scott, Phase III study comparing chemotherapy and radiotherapy with preoperative chemotherapy and surgical resection in patients with non-small-cell lung cancer with spread to mediastinal lymph nodes (N2); final report of RTOG 89-01 International Journal of Radiation Oncology Biology Physics. ,vol. 54, pp. 365- 369 ,(2002) , 10.1016/S0360-3016(02)02943-7
Bernard J. Park, Raja M. Flores, Cost comparison of robotic, video-assisted thoracic surgery and thoracotomy approaches to pulmonary lobectomy. Thoracic Surgery Clinics. ,vol. 18, pp. 297- 300 ,(2008) , 10.1016/J.THORSURG.2008.05.003
Godehard Friedel, Wilfried Budach, Juergen Dippon, Werner Spengler, Susanne Martina Eschmann, Christina Pfannenberg, Fawaz Al-Kamash, Thorsten Walles, Hermann Aebert, Thomas Kyriss, Stefanie Veit, Martin Kimmich, Michael Bamberg, Martin Kohlhaeufl, Volker Steger, Thomas Hehr, Phase II Trial of a Trimodality Regimen for Stage III Non–Small-Cell Lung Cancer Using Chemotherapy As Induction Treatment With Concurrent Hyperfractionated Chemoradiation With Carboplatin and Paclitaxel Followed by Subsequent Resection: A Single-Center Study Journal of Clinical Oncology. ,vol. 28, pp. 942- 948 ,(2010) , 10.1200/JCO.2008.21.7810
Karl L. Uy, Gail Darling, Wei Xu, Qi-Long Yi, Marc De Perrot, Andrew F. Pierre, Thomas K. Waddell, Michael R. Johnston, Andrea Bezjak, Frances A. Shepherd, Shaf Keshavjee, Improved results of induction chemoradiation before surgical intervention for selected patients with stage IIIA-N2 non-small cell lung cancer. The Journal of Thoracic and Cardiovascular Surgery. ,vol. 134, pp. 188- 193 ,(2007) , 10.1016/J.JTCVS.2007.01.078
Pascal A. Thomas, Julie Berbis, Jean-Marc Baste, Françoise Le Pimpec-Barthes, François Tronc, Pierre-Emmanuel Falcoz, Marcel Dahan, Anderson Loundou, Pneumonectomy for lung cancer: Contemporary national early morbidity and mortality outcomes The Journal of Thoracic and Cardiovascular Surgery. ,vol. 149, pp. 73- 83 ,(2015) , 10.1016/J.JTCVS.2014.09.063
Richard J Stephens, David J Girling, Penelope Hopwood, Nicholas Thatcher, Medical Research Council Lung Cancer Working Party, A randomised controlled trial of pre-operative chemotherapy followed, if feasible, by resection versus radiotherapy in patients with inoperable stage T3, N1, M0 or T1-3, N2, M0 non-small cell lung cancer. Lung Cancer. ,vol. 49, pp. 395- 400 ,(2005) , 10.1016/J.LUNGCAN.2005.04.001
Alessandro Brunelli, Cecilia Pompili, Michael Koller, Changes in Quality of Life After Pulmonary Resection Thoracic Surgery Clinics. ,vol. 22, pp. 471- 485 ,(2012) , 10.1016/J.THORSURG.2012.07.006
Kathy S Albain, R Suzanne Swann, Valerie W Rusch, Andrew T Turrisi, Frances A Shepherd, Colum Smith, Yuhchyau Chen, Robert B Livingston, Richard H Feins, David R Gandara, Willard A Fry, Gail Darling, David H Johnson, Mark R Green, Robert C Miller, Joanne Ley, Willliam T Sause, James D Cox, Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: a phase III randomised controlled trial The Lancet. ,vol. 374, pp. 379- 386 ,(2009) , 10.1016/S0140-6736(09)60737-6
Varun Puri, Traves D. Crabtree, Steven Kymes, Martin Gregory, Jennifer Bell, Jeffrey D. Bradley, Clifford Robinson, G. Alexander Patterson, Daniel Kreisel, Alexander S. Krupnick, Bryan F. Meyers, A comparison of surgical intervention and stereotactic body radiation therapy for stage I lung cancer in high-risk patients: A decision analysis The Journal of Thoracic and Cardiovascular Surgery. ,vol. 143, pp. 428- 436 ,(2012) , 10.1016/J.JTCVS.2011.10.078