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Cost–utility of sentinel lymph node biopsy in cT1–T2N0 oral cancer

Overview of attention for article published in Oral Oncology, November 2015
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Title
Cost–utility of sentinel lymph node biopsy in cT1–T2N0 oral cancer
Published in
Oral Oncology, November 2015
DOI 10.1016/j.oraloncology.2015.11.011
Pubmed ID
Authors

Naomi van der Linden, Géke B. Flach, Remco de Bree, Carin A. Uyl-de Groot

Abstract

To calculate the cost-utility of different strategies for the detection of occult lymph node metastases in cT1-T2N0 oral cancer. A decision tree followed by a Markov model was designed to compare the cost-utility of the following strategies: (a) USgFNAC (ultrasound guided fine needle aspiration cytology), (b) SLNB (sentinel lymph node biopsy), (c) USgFNAC and, if negative, SLNB (d) END (elective neck dissection). Data was collected from 62 patients in four Dutch head and neck centres. Utilities were measured with the EQ5D questionnaire and resource use was recorded from patient charts. Costs were calculated from a hospital perspective. Uncertainty was explored with scenario analyses and probabilistic sensitivity analyses. With a 5- or 10-year time horizon, SLNB results in the highest number of additional quality-adjusted life years (QALYs, 0.12 and 0.26, respectively) for the smallest additional costs (€56 and €74, respectively) compared to USgFNAC. With a lifetime horizon END results in the highest number of additional QALYs (0.55) for an additional €1.626 per QALY gained compared to USgFNAC. When we make different assumptions regarding the duration of disutilities (⩾5 years) or the improvement (⩾3%) of sensitivity of SLNB, SLNB is the most favourable strategy from all time horizons. SLNB is a good diagnostic strategy to evaluate cT1-T2N0 oral cancer. SLNB is the preferred strategy in a 5- or 10-year time horizon. From a lifetime horizon, END may be preferred. SLNB may become the optimal strategy from all time horizons if its sensitivity can be slightly improved.

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Geographical breakdown

Country Count As %
Unknown 50 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 9 18%
Student > Ph. D. Student 7 14%
Researcher 6 12%
Student > Bachelor 5 10%
Other 5 10%
Other 9 18%
Unknown 9 18%
Readers by discipline Count As %
Medicine and Dentistry 25 50%
Agricultural and Biological Sciences 3 6%
Nursing and Health Professions 3 6%
Biochemistry, Genetics and Molecular Biology 1 2%
Pharmacology, Toxicology and Pharmaceutical Science 1 2%
Other 4 8%
Unknown 13 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 December 2015.
All research outputs
#22,760,732
of 25,374,917 outputs
Outputs from Oral Oncology
#1,601
of 1,911 outputs
Outputs of similar age
#335,904
of 393,527 outputs
Outputs of similar age from Oral Oncology
#14
of 29 outputs
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We're also able to compare this research output to 29 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.