Low-Risk Papillary Thyroid Cancer: Treatment De-Escalation and Cost Implications.
J Surg Res
; 275: 273-280, 2022 07.
Article
en En
| MEDLINE
| ID: mdl-35306263
ABSTRACT
INTRODUCTION:
The American Thyroid Association (ATA) updated consensus guidelines in 2015 for radioactive iodine (RAI) and resection for low-risk papillary thyroid cancer. The objective of this study was to describe the evolution of institutional practice patterns and estimate the cost implications of these trends. MATERIALS ANDMETHODS:
Patients with cT1-T2N0 papillary thyroid cancer were identified via an institutional tumor registry. Incidences of total thyroidectomy or RAI were tracked longitudinally using cumulative sum. Real-world costs for RAI and each surgical encounter were adjusted for inflation and standardized to national average costs from National Inpatient Sample cost data.RESULTS:
Sixty-one patients met inclusion criteria between 2007 and 2018. Among these, 28 patients underwent total thyroidectomies and received RAI treatments based on criteria pre-dating the 2015 ATA guidelines. Cumulative sum revealed significant decreases in the rate of total thyroidectomy following May 2015 (15.8% versus 59.5%, P = 0.002) and RAI following March 2013 (3.0% versus 32.1%, P = 0.002). There were no locoregional recurrences in either period. The average cost savings attributable to these institutional practice changes was $1580 per patient.CONCLUSIONS:
De-escalation in surgical and RAI utilization for low-risk papillary thyroid cancer according to 2015 ATA guidelines is associated with a substantial decrease in real-world costs.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
Problema de salud:
1_doencas_nao_transmissiveis
/
1_financiamento_saude
/
2_muertes_prematuras_enfermedades_notrasmisibles
Asunto principal:
Neoplasias de la Tiroides
/
Radioisótopos de Yodo
Tipo de estudio:
Etiology_studies
/
Guideline
/
Health_economic_evaluation
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
J Surg Res
Año:
2022
Tipo del documento:
Article