Preferences and utilities for health states after treatment for oropharyngeal cancer: Transoral robotic surgery versus definitive (chemo)radiotherapy

Background Treatment of oropharyngeal cancer with transoral robotic surgery (TORS) or definitive (chemo)radiotherapy impacts quality of life. Utility scores are needed for quality of life and economic comparisons. Methods Fifty healthy subjects and 9 experts reviewed scenarios describing treatment (TORS alone or with adjuvant radiotherapy or chemoradiotherapy [CRT], definitive radiotherapy, and CRT), complications, remission, and recurrences. Utilities were assessed using visual analog scale (VAS) and standard gamble (SG) techniques. Treatments were compared using paired comparisons and demographic variability was assessed. Results TORS had higher SG utilities than radiotherapy (p =.001) and CRT (p <.001) and was preferred in paired comparisons (p <.001 for both) for healthy subjects. Utilities did not vary by demographic group and correlated between experts and subjects (VAS r = 0.95; p <.001; SG r = 0.97; p <.001). Conclusion TORS has higher utility scores than CRT. Utilities can be used for cost-utility analyses.