[Clinical and economic evaluation of the initial assessment of small cell cancer of the lung. Alternatives to classic evaluation. LGTO. The Lyon Group of Thoracic Oncology].
Alternatively to the usual evaluation summary, a characteristic of small cell lung cancer, is the probability of significant diffuse metastases; the prognosis is directly linked to the extent of these metastases. Moreover, the assessment of the initial extension becomes heavier and more costly as investigations continue and each new technology appears. In order to evaluate the contribution of each examination, a classification has been established as a function of the time-scale to obtain the results, of the technology involved, or whether the investigation is painful or not and any likelihood of iatrogenic side-effects. An assessment in three stages is proposed to achieve the most effective and cheapest diagnosis possible. In relation to the usual technique of assessment this sequential approach allows for a 27% reduction in the time-scale for the diagnosis of diffuse disease, 51.3% in terms of technical involvement, 46.3% in terms of pain and discomfort and 53.9% in terms of iatrogenic potential. At the same time a reduction in cost of 47.5% is observed.
Chauvin
F
F
Unité de Biostatistiques et Evaluation des Thérapeutiques, Centre Léon-Bérard, Lyon.
Souquet
P J
PJ
Trillet-Lenoir
V
V
Court-Fortune
I
I
Perol
M
M
Ecochard
D
D
Rebattu
P
P
Laennec
E
E
Bernard
J P
JP
D000469:Alkaline Phosphatase / Q000032:analysis; D001294:Attitude to Health; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D001859:Bone Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D018288:Carcinoma, Small Cell / Q000175:diagnosis* / Q000191:economics / Q000523:psychology / Q000556:secondary*; D003657:Decision Making; D003952:Diagnostic Imaging / Q000191:economics / Q000379:methods; D005069:Evaluation Studies as Topic; D006801:Humans; D007770:L-Lactate Dehydrogenase / Q000032:analysis; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000523:psychology; D008198:Lymph Nodes / Q000473:pathology; D009367:Neoplasm Staging / Q000191:economics / Q000379:methods; D011877:Radionuclide Imaging; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014463:Ultrasonography
D014408:Biomarkers, Tumor; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase
Evaluation clinique et économique du bilan initial des cancers du poumon à petites cellules. Alternatives à un bilan classique. GLOT. Groupe Lyonnais d'Oncologie Thoracique.