Cost-effectiveness analysis in papillary thyroid carcinoma patients with different neck dissection strategy: A retrospective cohort study

Kai Guo, Xiaoke Zheng, Duanshu Li, Yi Wu, Qinghai Ji, Zhuoying Wang

Research output: Contribution to journalArticle

Abstract

Background There are two surgical strategies for bilateral neck dissection (BND), simultaneous and two-stage operations. The aim of the study was to compare the cost-effectiveness BND with this two operations in papillary thyroid carcinoma (PTC) patients. Materials and methods Consecutive PTC patients undergoing BND were studied retrospectively, and were classified into simultaneous group (Group A) and two-stage group (Group B). Demographic, medical costs, complication and surgical variables were recorded. Results This study included 256 PTC patients, of which 175 (68.4%) underwent simultaneous BND and 81 (31.6%) patients underwent two-stage. Patients in Group B spent almost twice as much on medical costs as patients in Group A ($4145.3 vs. $7352.5). Group A patients also had shorter hospital stays (11.71 ± 5.12 vs. 23.10 ± 7.11, P <.0001) and surgery times (203.61 ± 61.43min vs. 279.58 ± 71.59min, P <.0001). The average radioactive iodine therapy delay was 67 days in Group B. There was no significant difference in complications (34 vs. 18, P =.605) or disease-free-survival (93.71% vs. 90.12%, P =.243) between the two groups. No difference was found in rates of recurrent laryngeal nerve invasion/resection (12 vs. 11, P =.08; 10 vs. 6, P =.353) or tracheotomy (32 vs. 14, P =.846). However, internal jugular vein invasions were more common in patients with two-stage BND (7 vs. 9, P =.029). Conclusion Simultaneous BND is the most cost-effective strategy for the management of PTC patients without bilateral internal jugular veins invasion, due to lower treatment cost and the ability to avoid RAI delay.

Original languageEnglish (US)
Pages (from-to)1-5
Number of pages5
JournalInternational Journal of Surgery
Volume50
DOIs
StatePublished - Feb 1 2018

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Neck Dissection
Cost-Benefit Analysis
Cohort Studies
Retrospective Studies
Jugular Veins
Costs and Cost Analysis
Recurrent Laryngeal Nerve
Papillary Thyroid cancer
Tracheotomy
Iodine
Health Care Costs
Disease-Free Survival
Length of Stay
Demography

Keywords

  • Neck dissection
  • Papillary thyroid carcinoma
  • Treatment costs

ASJC Scopus subject areas

  • Surgery

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Cost-effectiveness analysis in papillary thyroid carcinoma patients with different neck dissection strategy : A retrospective cohort study. / Guo, Kai; Zheng, Xiaoke; Li, Duanshu; Wu, Yi; Ji, Qinghai; Wang, Zhuoying.

In: International Journal of Surgery, Vol. 50, 01.02.2018, p. 1-5.

Research output: Contribution to journalArticle

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abstract = "Background There are two surgical strategies for bilateral neck dissection (BND), simultaneous and two-stage operations. The aim of the study was to compare the cost-effectiveness BND with this two operations in papillary thyroid carcinoma (PTC) patients. Materials and methods Consecutive PTC patients undergoing BND were studied retrospectively, and were classified into simultaneous group (Group A) and two-stage group (Group B). Demographic, medical costs, complication and surgical variables were recorded. Results This study included 256 PTC patients, of which 175 (68.4{\%}) underwent simultaneous BND and 81 (31.6{\%}) patients underwent two-stage. Patients in Group B spent almost twice as much on medical costs as patients in Group A ($4145.3 vs. $7352.5). Group A patients also had shorter hospital stays (11.71 ± 5.12 vs. 23.10 ± 7.11, P <.0001) and surgery times (203.61 ± 61.43min vs. 279.58 ± 71.59min, P <.0001). The average radioactive iodine therapy delay was 67 days in Group B. There was no significant difference in complications (34 vs. 18, P =.605) or disease-free-survival (93.71{\%} vs. 90.12{\%}, P =.243) between the two groups. No difference was found in rates of recurrent laryngeal nerve invasion/resection (12 vs. 11, P =.08; 10 vs. 6, P =.353) or tracheotomy (32 vs. 14, P =.846). However, internal jugular vein invasions were more common in patients with two-stage BND (7 vs. 9, P =.029). Conclusion Simultaneous BND is the most cost-effective strategy for the management of PTC patients without bilateral internal jugular veins invasion, due to lower treatment cost and the ability to avoid RAI delay.",
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AU - Guo, Kai

AU - Zheng, Xiaoke

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AU - Ji, Qinghai

AU - Wang, Zhuoying

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N2 - Background There are two surgical strategies for bilateral neck dissection (BND), simultaneous and two-stage operations. The aim of the study was to compare the cost-effectiveness BND with this two operations in papillary thyroid carcinoma (PTC) patients. Materials and methods Consecutive PTC patients undergoing BND were studied retrospectively, and were classified into simultaneous group (Group A) and two-stage group (Group B). Demographic, medical costs, complication and surgical variables were recorded. Results This study included 256 PTC patients, of which 175 (68.4%) underwent simultaneous BND and 81 (31.6%) patients underwent two-stage. Patients in Group B spent almost twice as much on medical costs as patients in Group A ($4145.3 vs. $7352.5). Group A patients also had shorter hospital stays (11.71 ± 5.12 vs. 23.10 ± 7.11, P <.0001) and surgery times (203.61 ± 61.43min vs. 279.58 ± 71.59min, P <.0001). The average radioactive iodine therapy delay was 67 days in Group B. There was no significant difference in complications (34 vs. 18, P =.605) or disease-free-survival (93.71% vs. 90.12%, P =.243) between the two groups. No difference was found in rates of recurrent laryngeal nerve invasion/resection (12 vs. 11, P =.08; 10 vs. 6, P =.353) or tracheotomy (32 vs. 14, P =.846). However, internal jugular vein invasions were more common in patients with two-stage BND (7 vs. 9, P =.029). Conclusion Simultaneous BND is the most cost-effective strategy for the management of PTC patients without bilateral internal jugular veins invasion, due to lower treatment cost and the ability to avoid RAI delay.

AB - Background There are two surgical strategies for bilateral neck dissection (BND), simultaneous and two-stage operations. The aim of the study was to compare the cost-effectiveness BND with this two operations in papillary thyroid carcinoma (PTC) patients. Materials and methods Consecutive PTC patients undergoing BND were studied retrospectively, and were classified into simultaneous group (Group A) and two-stage group (Group B). Demographic, medical costs, complication and surgical variables were recorded. Results This study included 256 PTC patients, of which 175 (68.4%) underwent simultaneous BND and 81 (31.6%) patients underwent two-stage. Patients in Group B spent almost twice as much on medical costs as patients in Group A ($4145.3 vs. $7352.5). Group A patients also had shorter hospital stays (11.71 ± 5.12 vs. 23.10 ± 7.11, P <.0001) and surgery times (203.61 ± 61.43min vs. 279.58 ± 71.59min, P <.0001). The average radioactive iodine therapy delay was 67 days in Group B. There was no significant difference in complications (34 vs. 18, P =.605) or disease-free-survival (93.71% vs. 90.12%, P =.243) between the two groups. No difference was found in rates of recurrent laryngeal nerve invasion/resection (12 vs. 11, P =.08; 10 vs. 6, P =.353) or tracheotomy (32 vs. 14, P =.846). However, internal jugular vein invasions were more common in patients with two-stage BND (7 vs. 9, P =.029). Conclusion Simultaneous BND is the most cost-effective strategy for the management of PTC patients without bilateral internal jugular veins invasion, due to lower treatment cost and the ability to avoid RAI delay.

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KW - Treatment costs

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