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The implementation of a noninvasive lymph node staging (NILS) preoperative prediction model is cost effective in primary breast cancer

Skarping, Ida (författare)
Lund University,Lunds universitet,Bröstcancer - prevention & intervention,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Bröstcancer,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Breast cancer prevention & intervention,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Breastcancer,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
Nilsson, Kristoffer (författare)
IHE – The Swedish Institute for Health Economics
Dihge, Looket (författare)
Lund University,Lunds universitet,Bröstcancerkirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Bröstcancerbehandling,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Breast Cancer Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Breast cancer treatment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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Fridhammar, Adam (författare)
IHE – The Swedish Institute for Health Economics
Ohlsson, Mattias (författare)
Lund University,Lunds universitet,Beräkningsbiologi och biologisk fysik - Har omorganiserats,Institutionen för astronomi och teoretisk fysik - Har omorganiserats,Naturvetenskapliga fakulteten,Artificiell intelligens och thoraxkirurgisk vetenskap (AICTS),Forskargrupper vid Lunds universitet,Computational Biology and Biological Physics - Has been reorganised,Department of Astronomy and Theoretical Physics - Has been reorganised,Faculty of Science,Artificial Intelligence in CardioThoracic Sciences (AICTS),Lund University Research Groups
Huss, Linnea (författare)
Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Kirurgi,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Bröstcancer,Sektion I,Institutionen för kliniska vetenskaper, Lund,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Surgery,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Breastcancer,Section I,Department of Clinical Sciences, Lund,Helsingborg Hospital
Bendahl, Pär Ola (författare)
Lund University,Lunds universitet,Individuell Bröstcancerbehandling,Forskargrupper vid Lunds universitet,The Liquid Biopsy och Tumörprogression i Bröstcancer,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Bröstcancerbehandling,Sektion I,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Personalized Breast Cancer Treatment,Lund University Research Groups,The Liquid Biopsy and Tumor Progression in Breast Cancer,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Breast cancer treatment,Section I,Department of Clinical Sciences, Lund,Faculty of Medicine
Steen Carlsson, Katarina (författare)
Lund University,Lunds universitet,Hälsoekonomi,Forskargrupper vid Lunds universitet,Health Economics,Lund University Research Groups,IHE – The Swedish Institute for Health Economics
Rydén, Lisa (författare)
Lund University,Lunds universitet,Kirurgi, Lund,Sektion V,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Bröstcancerkirurgi,Forskargrupper vid Lunds universitet,The Liquid Biopsy och Tumörprogression i Bröstcancer,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Bröstcancerbehandling,Sektion I,Institutionen för kliniska vetenskaper, Lund,Surgery (Lund),Section V,Department of Clinical Sciences, Lund,Faculty of Medicine,Breast Cancer Surgery,Lund University Research Groups,The Liquid Biopsy and Tumor Progression in Breast Cancer,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Breast cancer treatment,Section I,Department of Clinical Sciences, Lund,Skåne University Hospital
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 (creator_code:org_t)
2022-07-05
2022
Engelska 10 s.
Ingår i: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 0167-6806 .- 1573-7217. ; 194:3, s. 577-586
Relaterad länk:
http://dx.doi.org/10... (free)
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https://lup.lub.lu.s...
https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Purpose: The need for sentinel lymph node biopsy (SLNB) in clinically node-negative (cN0) patients is currently questioned. Our objective was to investigate the cost-effectiveness of a preoperative noninvasive lymph node staging (NILS) model (an artificial neural network model) for predicting pathological nodal status in patients with cN0 breast cancer (BC). Methods: A health-economic decision-analytic model was developed to evaluate the utility of the NILS model in reducing the proportion of cN0 patients with low predicted risk undergoing SLNB. The model used information from a national registry and published studies, and three sensitivity/specificity scenarios of the NILS model were evaluated. Subgroup analysis explored the outcomes of breast-conserving surgery (BCS) or mastectomy. The results are presented as cost (€) and quality-adjusted life years (QALYs) per 1000 patients. Results: All three scenarios of the NILS model reduced total costs (–€93,244 to –€398,941 per 1000 patients). The overall health benefit allowing for the impact of SLNB complications was a net health gain (7.0–26.9 QALYs per 1000 patients). Sensitivity analyses disregarding reduced quality of life from lymphedema showed a small loss in total health benefits (0.4–4.0 QALYs per 1000 patients) because of the reduction in total life years (0.6–6.5 life years per 1000 patients) after reduced adjuvant treatment. Subgroup analyses showed greater cost reductions and QALY gains in patients undergoing BCS. Conclusion: Implementing the NILS model to identify patients with low risk for nodal metastases was associated with substantial cost reductions and likely overall health gains, especially in patients undergoing BCS.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Artificial neural network
Axillary lymph nodes
Breast neoplasm
Cost-effectiveness
Staging

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