Impact of different follow-up regimens on health-related quality of life and costs in endometrial cancer patients: Results from the TOTEM randomized trial.
Gynecol Oncol
; 184: 150-159, 2024 05.
Article
em En
| MEDLINE
| ID: mdl-38309033
ABSTRACT
PURPOSE:
To investigate whether intensive follow-up (INT) after surgery for endometrial cancer impact health-related quality of life (HRQoL) and healthcare costs compared to minimalist follow-up (MIN), in the absence of evidence supporting any benefit on 5-year overall survival.METHODS:
In the TOTEM trial, HRQoL was assessed using the SF-12 and the Psychological General Well-Being (PGWB) questionnaires at baseline, after 6 and 12 months and then annually up to 5 years of follow-up. Costs were analyzed after 4 years of follow-up from a National Health Service perspective, stratified by risk level. The probability of missing data was analyzed for both endpoints.RESULTS:
1847 patients were included in the analyses. The probability of missing data was not influenced by the study arms (MIN vs INT OR 0.97 95%CI 0.87-1.08). Longitudinal changes in HRQoL scores did not differ between the two follow-up regimens (MIN vs INT SF-12 PCS -0.573, CI95% -1.31; 0.16; SF-12 MCS -0.243, CI95% -1.08; 0.59; PGWB -0.057, CI95% -0,88; 0,77). The mean cost difference between the intensive and minimalist arm was 531 for low-risk patients and 683 for high-risk patients.CONCLUSION:
In the follow-up of endometrial cancer after surgery, a minimalist treatment regimen did not affect quality of life and was cost-saving in both low-risk and high-risk recurrence patients. As previous results showed no survival benefit, a minimalist approach is justified. The relevant proportion of missing data on secondary outcomes of interest could be a critical point that deserves special attention.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Neoplasias do Endométrio
Tipo de estudo:
Clinical_trials
/
Health_economic_evaluation
Limite:
Aged
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Female
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Humans
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Middle aged
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article