Treatment for early endometrial cancer. Cost-effectiveness analysis.
OBJECTIVE
To evaluate the cost-effectiveness of treatment for early endometrial cancer.


METHODS
Cost-minimization type of cost-effectiveness analysis with payer costs based on CPT (physician's current procedural terminology) and DRG (disease related group) codes. The six principles of cost-effectiveness analysis were evaluated. We compared the standard treatment protocol of selected lymphadenectomy/selective teletherapy (lymphadenectomy and postoperative teletherapy administered for high-risk tumors) as performed by the majority of gynecologic oncologists vs. an alternate treatment protocol of lymphadenectomy/selective brachytherapy (lymphadenectomy for all tumors, brachytherapy for high-risk tumors and teletherapy reserved for nodal metastasis) as performed by 10-12% of gynecologic oncologists.


RESULTS
In cost-minimization analysis, lymphadenectomy/selective brachytherapy was 12% less expensive than the standard treatment protocol of selective lymphadenectomy/teletherapy.


CONCLUSIONS
Although only 10-12% of gynecologic oncologists perform lymphadenectomy on all patients, deliver brachytherapy for high-risk tumors and reserve teletherapy for lymph node metastasis, it is a cost-effective treatment strategy for early endometrial cancer.
Fanning
J
J
Department of Obstetrics and Gynecology, Medical College of Ohio, Toledo 43614-5809, USA.
D001918:Brachytherapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D016889:Endometrial Neoplasms / Q000191:economics* / Q000473:pathology / Q000628:therapy; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008197:Lymph Node Excision / Q000191:economics*; D009017:Morbidity; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis