Impact of 18FFDG-PET/CT and Laparoscopy in Staging of Locally Advanced Gastric Cancer: A Cost Analysis in the Prospective Multicenter PLASTIC-Study

被引：2

作者：

de Jongh, Cas ^{[1
]}

van der Meulen, Miriam P. ^{[2
]}

Gertsen, Emma C. ^{[1
]}

Brenkman, Hylke J. F. ^{[1
]}

van Sandick, Johanna W. ^{[3
]}

van Berge Henegouwen, Mark I. ^{[4
,5
]}

Gisbertz, Suzanne S. ^{[4
,5
]}

Luyer, Misha D. P. ^{[6
]}

Nieuwenhuijzen, Grard A. P. ^{[6
]}

van Lanschot, Jan J. B. ^{[7
]}

Lagarde, Sjoerd M. ^{[7
]}

Wijnhoven, Bas P. L. ^{[7
]}

de Steur, Wobbe O. ^{[8
]}

Hartgrink, Henk H. ^{[8
]}

Stoot, Jan H. M. B. ^{[9
]}

Hulsewe, Karel W. E. ^{[9
]}

Spillenaar Bilgen, Ernst Jan ^{[10
]}

van Det, Marc J. ^{[11
]}

Kouwenhoven, Ewout A. ^{[11
]}

Daams, Freek ^{[5
,12
]}

van der Peet, Donald L. ^{[5
,12
]}

van Grieken, Nicole C. T. ^{[5
,12
]}

Heisterkamp, Joos ^{[13
]}

van Etten, Boudewijn ^{[14
]}

van den Berg, Jan-Willem ^{[14
]}

Pierie, Jean-Pierre ^{[15
]}

Eker, Hasan H. ^{[15
]}

Thijssen, Annemieke Y. ^{[16
]}

Belt, Eric J. T. ^{[16
]}

van Duijvendijk, Peter ^{[17
]}

Wassenaar, Eelco ^{[17
]}

Wevers, Kevin P. ^{[18
]}

Hol, Lieke ^{[19
]}

Wessels, Frank J. ^{[1
]}

Haj Mohammad, Nadia ^{[1
]}

Frederix, Geert W. J. ^{[2
]}

van Hillegersberg, Richard ^{[1
]}

Siersema, Peter D. ^{[20
]}

Vegt, Erik ^{[3
,7
]}

Ruurda, Jelle P. ^{[1
]}

机构：

[1] UMC Utrecht, Dept Surg Med Oncol & Radiol, Univ Med Ctr, Utrecht, Netherlands

[2] UMC Utrecht, Julius Ctr Hlth Sci & Primary Care, Utrecht, Netherlands

[3] Netherlands Canc Inst Antoni Leeuwenhoek, Surg & Nucl Med Dept, Amsterdam, Netherlands

[4] Locat Univ Amsterdam, Surg Dept, Amsterdam UMC, Amsterdam, Netherlands

[5] Canc Ctr Amsterdam, Surg & Pathol Dept, Amsterdam, Netherlands

[6] Catharina Hosp, Surg Dept, Eindhoven, Netherlands

[7] UMC Rotterdam, Surg & Nucl Med Dept, Erasmus Med Ctr, Rotterdam, Netherlands

[8] Leiden UMC, Surg Dept, Leiden, Netherlands

[9] Zuyderland MC, Surg Dept, Geleen, Netherlands

[10] Rijnstate Hosp, Surg Dept, Arnhem, Netherlands

[11] ZGT Hosp, Surg Dept, Almelo, Netherlands

[12] Amsterdam UMC, Locat Vrije Univ, Surg & Pathol Dept, Amsterdam, Netherlands

[13] Elisabeth Twee Steden Hosp, Surg Dept, Tilburg, Netherlands

[14] Univ Med Ctr Groningen, Surg Dept, Groningen, Netherlands

[15] Med Ctr Leeuwarden, Surg Dept, Leeuwarden, Netherlands

[16] Albert Schweitzer Hosp, Gastroenterol Dept, Dordrecht, Netherlands

[17] Gelre Hosp, Surg Dept, Apeldoorn, Netherlands

[18] Isala Hosp, Surg Dept, Zwolle, Netherlands

[19] Maasstad Hosp, Gastroenterol Dept, Rotterdam, Netherlands

[20] Erasmus MC Univ Med Ctr, Gastroenterol & Hepatol Dept, Rotterdam, Netherlands

来源：

ANNALS OF SURGICAL ONCOLOGY | 2024年 / 31卷 / 6期

关键词：

Gastric cancer; Costs; Staging; Positron emission tomography; Laparoscopy; Gastrectomy; POSITRON-EMISSION-TOMOGRAPHY; GASTROINTESTINAL CANCER; CHEMOTHERAPY; SURGERY; TUMOR;

D O I：

10.1245/s10434-024-15103-4

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background Unnecessary D2-gastrectomy and associated costs can be prevented after detecting non-curable gastric cancer, but impact of staging on treatment costs is unclear. This study determined the cost impact of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18FFDG-PET/CT) and staging laparoscopy (SL) in gastric cancer staging. Materials and Methods In this cost analysis, four staging strategies were modeled in a decision tree: (1) 18FFDG-PET/CT first, then SL, (2) SL only, (3) 18FFDG-PET/CT only, and (4) neither SL nor 18FFDG-PET/CT. Costs were assessed on the basis of the prospective PLASTIC-study, which evaluated adding 18FFDG-PET/CT and SL to staging advanced gastric cancer (cT3-4 and/or cN+) in 18 Dutch hospitals. The Dutch Healthcare Authority provided 18FFDG-PET/CT unit costs. SL unit costs were calculated bottom-up. Gastrectomy-associated costs were collected with hospital claim data until 30 days postoperatively. Uncertainty was assessed in a probabilistic sensitivity analysis (1000 iterations). Results 18FFDG-PET/CT costs were euro1104 including biopsy/cytology. Bottom-up calculations totaled euro1537 per SL. D2-gastrectomy costs were euro19,308. Total costs per patient were euro18,137 for strategy 1, euro17,079 for strategy 2, and euro19,805 for strategy 3. If all patients undergo gastrectomy, total costs were euro18,959 per patient (strategy 4). Performing SL only reduced costs by euro1880 per patient. Adding 18FFDG-PET/CT to SL increased costs by euro1058 per patient; IQR euro870-1253 in the sensitivity analysis. Conclusions For advanced gastric cancer, performing SL resulted in substantial cost savings by reducing unnecessary gastrectomies. In contrast, routine 18FFDG-PET/CT increased costs without substantially reducing unnecessary gastrectomies, and is not recommended due to limited impact with major costs. Trial registration: NCT03208621. This trial was registered prospectively on 30-06-2017. Conclusions For advanced gastric cancer, performing SL resulted in substantial cost savings by reducing unnecessary gastrectomies. In contrast, routine 18FFDG-PET/CT increased costs without substantially reducing unnecessary gastrectomies, and is not recommended due to limited impact with major costs. Trial registration: NCT03208621. This trial was registered prospectively on 30-06-2017.

引用

页码：4005 / 4017

页数：13

共 50 条

[21] When to do PET-CT and diagnostic laparoscopy in gall bladder cancer? A prospective study to assess the role of PET-CT and diagnostic laparoscopy in the staging of gall bladder cancer
Kumar, S.
Bhoriwal, S.
Deo, S.
Sharma, A.
Kumar, R.
[J]. ANNALS OF ONCOLOGY, 2020, 31 : S146 - S147
[22] A multicenter, prospective study of apatinib plus chemotherapy as neoadjuvant treatment for locally advanced gastric cancer
Tang, Y-H.
Wang, F-H.
Lin, G-J.
Lin, J-X.
Zheng, C-H.
Li, P.
Xie, J-W.
Wang, J-B.
Lu, J.
Chen, Q-Y.
Cao, L-L.
Lin, M.
Tu, R-H.
Huang, Z-N.
Lin, J-L.
Zheng, H-L.
Huang, C.
[J]. ANNALS OF ONCOLOGY, 2020, 31 : S1300 - S1300
[23] ROLE OF PET-CT SCAN IN LOCALLY ADVANCED HEAD & NECK CANCER: A Prospective Study
Mohammad, Akheel
Bhargava, Anuj
Wadhwania, Ashmi
[J]. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS, 2015, 3 (03):
[24] ROLE OF PET-CT SCAN IN LOCALLY ADVANCED HEAD & NECK CANCER: A Prospective Study
Mohammad, Akheel
Bhargava, Anuj
Wadhwania, Ashmi
[J]. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS, 2015, 3 (02):
[25] ROLE OF PET-CT SCAN IN LOCALLY ADVANCED HEAD & NECK CANCER: A Prospective Study
Mohammad, Akheel
Bhargava, Anuj
Wadhwania, Ashmi
[J]. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS, 2013, 1 (02): : 31 - +
[26] ROLE OF PET-CT SCAN IN LOCALLY ADVANCED HEAD & NECK CANCER: A Prospective Study
Mohammad, Akheel
Bhargava, Anuj
Wadhwania, Ashmi
[J]. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS, 2014, 2 (01): : 31 - +
[27] ROLE OF PET-CT SCAN IN LOCALLY ADVANCED HEAD & NECK CANCER: A Prospective Study
Mohammad, Akheel
Bhargava, Anuj
Wadhwania, Ashmi
[J]. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS, 2015, 3 (01): : 31 - U32
[28] ROLE OF PET-CT SCAN IN LOCALLY ADVANCED HEAD & NECK CANCER: A Prospective Study
Mohammad, Akheel
Bhargava, Anuj
Wadhwania, Ashmi
[J]. JOURNAL OF HEAD & NECK PHYSICIANS AND SURGEONS, 2014, 2 (02): : 31 - +
[29] A prospective randomized multicenter study on the impact of 18F-Choline PET/CT versus conventional imaging for staging intermediate - to high-risk prostate cancer
Evangelista, L.
Zattoni, F.
Borsasti, E.
Trifro, G.
Farsad, M.
Trenti, E.
Chierichetti, F.
Bartolomei, M.
Cracco, E.
Bombardieri, E.
Dal Moro, F.
Del Bianco, P.
Magni, G.
De Salvo, G. L.
Novara, G.
[J]. EUROPEAN UROLOGY, 2024, 85 : S1291 - S1291
[30] Prognostic value of [18F]FDG PET radiomics to detect peritoneal and distant metastases in locally advanced gastric cancer - a side-study of the prospective multicentre PLASTIC study
Noortman, W. A.
Pullen, L. C. E.
Triemstra, L.
de Jongh, C.
Rademaker, F. J.
Spijkerman, R.
Kalisvaart, G. M.
Gertsen, E. C.
de Geus-Oei, L. F.
Tolboom, N.
de Steur, W. O.
Dantuma, M.
Slart, R. H. J. A.
van Hillegersberg, R.
Siersema, P. D.
Ruurda, J. P.
van Velden, F. H. P.
Vegt, E.
[J]. EUROPEAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING, 2023, 50 (SUPPL 1) : S41 - S41

← 1 2 3 4 5 →