Cost-effectiveness analysis in papillary thyroid carcinoma patients with different neck dissection strategy: A retrospective cohort study.
Int J Surg
; 50: 1-5, 2018 Feb.
Article
em En
| MEDLINE
| ID: mdl-29278752
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 ANDMETHODS:
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⯱â¯5.12 vs. 23.10⯱â¯7.11, Pâ¯<â¯.0001) and surgery times (203.61⯱â¯61.43min vs. 279.58⯱â¯71.59min, Pâ¯<â¯.0001). The average radioactive iodine therapy delay was 67 days in Group B. There was no significant difference in complications (34 vs. 18, Pâ¯=â¯.605) or disease-free-survival (93.71% vs. 90.12%, Pâ¯=â¯.243) between the two groups. No difference was found in rates of recurrent laryngeal nerve invasion/resection (12 vs. 11, Pâ¯=â¯.08; 10 vs. 6, Pâ¯=â¯.353) or tracheotomy (32 vs. 14, Pâ¯=â¯.846). However, internal jugular vein invasions were more common in patients with two-stage BND (7 vs. 9, Pâ¯=â¯.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.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Esvaziamento Cervical
/
Neoplasias da Glândula Tireoide
/
Carcinoma Papilar
/
Custos de Cuidados de Saúde
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article