User menu

Accès à distance ? S'identifier sur le proxy UCLouvain

Cost-effectiveness analysis of FDG PET-CT in the management of pulmonary metastases from malignant melanoma

Primary tabs

Krug, Bruno [UCL] Crott, Ralph [UCL] Roch, Isabelle [UCL] Lonneux, Max [UCL] Beguin, Claire [UCL] Baurain, Jean-François [UCL] Pirson, Anne-Sophie [UCL] Vander Borght, Thierry [UCL]

Objectives. Most guidelines consider FDG PET-CT to detect occult extra-pulmonary disease prior to lung metastasectomy. A cost-effectiveness analysis, using a Markov model over a 10 year period, was performed to compare two different surveillance programs, either PET-CT or whole-body CT, in patients with suspected pulmonary metastasised melanoma. Methods. Data from published studies provided probabilities for the model. Complication and care costs were obtained from standardised administrative databases from 19 hospitals identified by DRG codes (reported in 2009 Euros). For the cost calculation of PET-CT we performed a microcosting analysis. All costs and benefits were yearly discounted at respectively 3% and 1.5%. Outcomes included life-months gained (LMG) and the number of futile surgeries avoided. Cost-effectiveness ratios were in Euros per LMG. Univariate and probabilistic sensitivity analyses addressed uncertainty in all model parameters. Results. The PET-CT strategy provided 86.29 LMG (95% CI: 81.50-90.88 LMG) at a discounted cost of euro3 974 (95% CI: euro1 339-12 303), while the conventional strategy provided 86.08 LMG (95% CI: 81.37-90.68 LMG) at a discounted cost of euro5 022 (95% CI: euro1 378-16 018). This PET-CT strategy resulted in a net saving of euro1 048 with a gain of 0.2 LMG. Based on PET-CT findings, 20% of futile surgeries could be avoided. Conclusion. Integrating PET-CT in the management of patients with high risk MM appears to be less costly and more accurate by avoiding futile thoracotomies in one of five patients as well as by providing a small survival benefit at 10 years.

Document type Article de périodique (Journal article) – Article de recherche – Journal Article
Access type Accès restreint
Publication date 2010
Language Anglais
Journal information "Acta Oncologica" - Vol. 49, no. 2, p. 192-200 (2010)
Peer reviewed yes
Publisher Informa Healthcare ((United Kingdom) London)
issn 0284-186X
e-issn 1651-226X
Publication status Publié
Affiliations UCL - SSS/IREC - Institut de recherche expérimentale et clinique
UCL - SSS/IRSS - Institut de recherche santé et société
UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie
UCL - (MGD) Service de médecine nucléaire
UCL - (SLuc) Service de médecine nucléaire
UCL - (SLuc) Unité d'oncologie médicale
UCL - SSS/IREC/MONT - Pôle Mont Godinne
MESH Subject Tomography, X-Ray Computed - economics ; Skin Neoplasms - diagnosis - economics ; Radiopharmaceuticals - diagnostic use - economics ; Positron-Emission Tomography - economics ; Melanoma - diagnosis - economics - secondary ; Lung Neoplasms - diagnosis - economics - secondary ; Humans ; Fluorodeoxyglucose F18 - diagnostic use - economics ; Cost-Benefit Analysis
Links
  1. Balch C. M., Soong S.-J., Atkins M. B., Buzaid A. C., Cascinelli N., Coit D. G., Fleming I. D., Gershenwald J. E., Houghton A., Kirkwood J. M., McMasters K. M., Mihm M. F., Morton D. L., Reintgen D. S., Ross M. I., Sober A., Thompson J. A., Thompson J. F., An Evidence-based Staging System for Cutaneous Melanoma, 10.3322/canjclin.54.3.131
  2. Lee ML, Melanoma Res, 10, 81 (2000)
  3. Harpole DH, J Thorac Cardiovasc Surg, 103, 743 (1992)
  4. Petersen Rebecca P., Hanish Steven I., Haney John C., Miller Charles C., Burfeind William R., Tyler Douglas S., Seigler Hilliard F., Wolfe Walter, D’Amico Thomas A., Harpole David H., Improved survival with pulmonary metastasectomy: An analysis of 1720 patients with pulmonary metastatic melanoma, 10.1016/j.jtcvs.2006.08.065
  5. Tafra Lorraine, Dale Paul S., Wanek Leslie A., Ramming Kenneth P., Morton Donald L., Resection and adjuvant immunotherapy for melanoma metastatic to the lung and thorax, 10.1016/s0022-5223(05)80017-0
  6. Conilla Carlos, Gimferrer José María, Marruecos Jordi, Domingo-Domènech Josep, Vilella Ramón, Catalán Miquel, Malvehy Josep, Puig Susana, Castel Teresa, Clinical outcome after surgical resection of lung metastases from melanoma, 10.1007/s12094-007-0009-4
  7. Hillner Bruce E., Kirkwood John M., Agarwala Sanjiv S., Burden of illness associated with metastatic melanoma : An audit of 100 consecutive referral center cases, 10.1002/1097-0142(20010501)91:9<1814::aid-cncr1201>3.0.co;2-w
  8. Jost L. M., ESMO Minimum Clinical Recommendations for diagnosis, treatment and follow-up of cutaneous malignant melanoma, 10.1093/annonc/mdi809
  9. Dummer R., Panizzon R., Bloch P.H., Burg G., Updated Swiss Guidelines for the Treatment and Follow-Up of Cutaneous Melanoma, 10.1159/000081482
  10. Garbe Claus, A Rational Approach to the Follow-up of Melanoma Patients, Cancers of the Skin (2002) ISBN:9783642639692 p.205-215, 10.1007/978-3-642-59410-6_24
  11. Ollila David W, Complete metastasectomy in patients with stage IV metastatic melanoma, 10.1016/s1470-2045(06)70938-x
  12. Young Shawn E., Martinez Steve R., Essner Richard, The role of surgery in treatment of stage IV melanoma, 10.1002/jso.20303
  13. Ollila David W., Caudle Abigail S., Surgical Management of Distant Metastases, 10.1016/j.soc.2005.12.003
  14. Mosca Paul J., Teicher Erik, Nair Suresh P., Pockaj Barbara A., Can surgeons improve survival in stage IV melanoma?, 10.1002/jso.20950
  15. Neuman Heather B., Patel Ami, Hanlon Christine, Wolchok Jedd D., Houghton Alan N., Coit Daniel G., Stage-IV Melanoma and Pulmonary Metastases: Factors Predictive of Survival, 10.1245/s10434-007-9448-y
  16. Leo F, Cagini L, Rocmans P, Cappello M, Geel A N Van, Maggi G, Goldstraw P, Pastorino U, Lung metastases from melanoma: when is surgical treatment warranted?, 10.1054/bjoc.2000.1335
  17. Chevalier Julie, Bonastre Julia, Avril Marie-Françoise, The economic burden of melanoma in France: assessing healthcare use in a hospital setting : , 10.1097/cmr.0b013e3282f36203
  18. Harris Marion T., Berlangieri Salvatore U., Cebon Jonathan S., Davis Ian D., Scott Andrew M., Impact of 2-Deoxy-2[F-18]Fluoro-d-Glucose Positron Emission Tomography on the Management of Patients with Advanced Melanoma, 10.1007/s11307-005-0002-7
  19. Dalrymple-Hay M.J.R., Rome P.D., Kennedy C., Fulham M., McCaughan B.C., Pulmonary metastatic melanoma — the survival benefit associated with positron emission tomography scanning, 10.1016/s1010-7940(02)00026-x
  20. Essner Richard, Belhocine Tarik, Scott Andrew M., Even-Sapir Einat, Novel Imaging Techniques in Melanoma, 10.1016/j.soc.2005.12.009
  21. Krug Bruno, Crott Ralph, Lonneux Max, Baurain Jean-François, Pirson Anne-Sophie, Vander Borght Thierry, Role of PET in the Initial Staging of Cutaneous Malignant Melanoma: Systematic Review, 10.1148/radiol.2493080240
  22. Garbe Claus, Hauschild Axel, Volkenandt Matthias, Schadendorf Dirk, Stolz Wilhelm, Reinhold Uwe, Kortmann Rolf-Dieter, Kettelhack Christoph, Frerich Bernhard, Keilholz Ulrich, Dummer Reinhard, Sebastian Günther, Tilgen Wolfgang, Schuler Gerold, Mackensen Andreas, Kaufmann Roland, Evidence and interdisciplinary consense-based German guidelines: diagnosis and surveillance of melanoma : , 10.1097/cmr.0b013e3282f05039
  23. Choi Eugene A., Gershenwald Jeffrey E., Imaging Studies in Patients with Melanoma, 10.1016/j.soc.2007.03.004
  24. Fletcher J. W., Djulbegovic B., Soares H. P., Siegel B. A., Lowe V. J., Lyman G. H., Coleman R. E., Wahl R., Paschold J. C., Avril N., Einhorn L. H., Suh W. W., Samson D., Delbeke D., Gorman M., Shields A. F., Recommendations on the Use of 18F-FDG PET in Oncology, 10.2967/jnumed.107.047787
  25. Dummer R, Ann Oncol, 19, ii86 (2008)
  26. Briggs Andrew, Sculpher Mark, An Introduction to Markov Modelling for Economic Evaluation : , 10.2165/00019053-199813040-00003
  27. Ollila David W., Hsueh Eddy C., Stern Stacey L., Morton Donald L., Metastasectomy for recurrent stage IV melanoma, 10.1002/(sici)1096-9098(199908)71:4<209::aid-jso1>3.0.co;2-2
  28. Pastorino Ugo, Buyse Marc, Friedel Godehard, Ginsberg Robert J., Girard Philippe, Goldstraw Peter, Johnston Michael, McCormack Patricia, Pass Harvey, Putnam Joe B., Long-term results of lung metastasectomy: Prognostic analyses based on 5206 cases, 10.1016/s0022-5223(97)70397-0
  29. Cashin Richard P., Lui Philip, Machado Márcio, Hemels Michiel E.H., Corey-Lisle Patricia K., Einarson Thomas R., Advanced Cutaneous Malignant Melanoma: A Systematic Review of Economic and Quality-of-Life Studies, 10.1111/j.1524-4733.2007.00243.x
  30. Mooney Margaret M., Mettlin Curtis, Michalek Arthur M., Petrelli Nicholas J., Kraybill William G., Life-long screening of patients with intermediate-thickness cutaneous melanoma for asymptomatic pulmonary recurrences : A cost-effectiveness analysis, 10.1002/(sici)1097-0142(19970915)80:6<1052::aid-cncr7>3.0.co;2-b
  31. Sterftetafels 2006: Verwachte levensduur, sterftekans en overlevingskans. 2006.
  32. Nashan D, Müller ML, Grabbe S, Wustlich S, Enk A, Systemic therapy of disseminated malignant melanoma: an evidence-based overview of the state-of-the-art in daily routine, 10.1111/j.1468-3083.2007.02475.x
  33. Tawbi Hussein A., Kirkwood John M., Management of Metastatic Melanoma, 10.1053/j.seminoncol.2007.09.008
  34. Lui Philip, Cashin Richard, Machado Márcio, Hemels Michiel, Corey-Lisle Patricia K., Einarson Thomas R., Treatments for metastatic melanoma: Synthesis of evidence from randomized trials, 10.1016/j.ctrv.2007.06.004
  35. Tarhini Ahmad A., Agarwala Sanjiv S., Cutaneous melanoma: available therapy for metastatic disease, 10.1111/j.1529-8019.2005.00052.x
  36. Eggermont Alexander M.M, Kirkwood John M, Re-evaluating the role of dacarbazine in metastatic melanoma: what have we learned in 30 years?, 10.1016/j.ejca.2004.04.030
  37. Cleemput I, KCE reports 78A (2008)
  38. Krug B, Health Policy (2009)
  39. Pastorino Ugo, History of the surgical management of pulmonary metastases and development of the International Registry, 10.1053/stcs.2002.32881
  40. Francken Anne Brecht, Shaw Helen M., Accortt Neil A., Soong Seng-Jaw, Hoekstra Harald J., Thompson John F., Detection of First Relapse in Cutaneous Melanoma Patients: Implications for the Formulation of Evidence-Based Follow-up Guidelines, 10.1245/s10434-007-9347-2
  41. Roberts D.L.L., Anstey A.V., Barlow R.J., Cox N.H., Bishop J.A. Newton, Corrie P.G., Evans J., Gore M.E., Hall P.N., Kirkham N., , U.K. guidelines for the management of cutaneous melanoma : U.K. GUIDELINES FOR THE MANAGEMENT OF CUTANEOUS MELANOMA, 10.1046/j.1365-2133.2001.04614.x
  42. Garbe Claus, Hauschild Axel, Volkenandt Matthias, Schadendorf Dirk, Stolz Wilhelm, Reinhold Uwe, Kortmann Rolf-Dieter, Kettelhack Christoph, Frerich Bernhard, Keilholz Ulrich, Dummer Reinhard, Sebastian Günther, Tilgen Wolfgang, Schuler Gerold, Mackensen Andreas, Kaufmann Roland, Evidence and interdisciplinary consensus-based German guidelines: surgical treatment and radiotherapy of melanoma : , 10.1097/cmr.0b013e3282f0c893
  43. Allen Peter J., Coit Daniel G., The surgical management of metastatic melanoma, 10.1007/bf02574498
  44. Hofmann U, Szedlak M, Rittgen W, Jung E G, Schadendorf D, Primary staging and follow-up in melanoma patients – monocenter evaluation of methods, costs and patient survival, 10.1038/sj.bjc.6600428
  45. Agnese Doreen M, Abdessalam Shahab F, Burak William E, Magro Cynthia M, Pozderac Rodney V, Walker Michael J, Cost-effectiveness of sentinel lymph node biopsy in thin melanomas, 10.1016/s0039-6060(03)00275-7
  46. Hengge Ulrich R., Wallerand Andrea, Stutzki Andreas, Kockel Norbert, Cost-effectiveness of reduced follow-up in malignant melanoma, 10.1111/j.1610-0387.2007.06454.x
  47. Bassères N., Grob J.J., Richard M.A., Thirion X., Zarour H., Noe C., Collet-Vilette A.M., Lota I., Bonerandi J.J., Cost-Effectiveness of Surveillance of Stage I Melanoma, 10.1159/000246546
  48. Zubeldia Jose M., Bednarczyk Edward M., Baker John G., Nabi Hani A., The Economic Impact of18FDG Positron Emission Tomography in the Surgical Management of Colorectal Cancer with Hepatic Metastases, 10.1089/cbr.2005.20.450
  49. Park Kenneth C., Schwimmer Judy, Gambhir Sanjiv S., LETTERS TO THE EDITOR : , 10.1097/00000658-200202000-00023
  50. Belhocine TZ, J Nucl Med, 47, 957 (2006)
  51. Iagaru A., Quon A., Johnson D., Gambhir S. S., McDougall I. R., 2-Deoxy-2-[F-18]fluoro-d-glucose Positron Emission Tomography/Computed Tomography in the Management of Melanoma, 10.1007/s11307-006-0065-0
  52. Reinhardt Michael J., Joe Alexius Y., Jaeger Ursula, Huber Andrea, Matthies Alexander, Bucerius Jan, Roedel Roland, Strunk Holger, Bieber Thomas, Biersack Hans-Juergen, Tüting Thomas, Diagnostic Performance of Whole Body Dual Modality18F-FDG PET/CT Imaging for N- and M-Staging of Malignant Melanoma: Experience With 250 Consecutive Patients, 10.1200/jco.2005.03.5634
  53. Essner Richard, Contemporary Surgical Treatment of Advanced-Stage Melanoma, 10.1001/archsurg.139.9.961
  54. Pfannschmidt Joachim, Dienemann Hendrik, Hoffmann Hans, Surgical Resection of Pulmonary Metastases From Colorectal Cancer: A Systematic Review of Published Series, 10.1016/j.athoracsur.2007.02.093
  55. Mountain Clifton F., McMurtrey Marion J., Hermes Kay E., Surgery for Pulmonary Metastasis: A 20-Year Experience, 10.1016/s0003-4975(10)62280-1
  56. Koodziejski L., Góralczyk J., Dyczek S., Duda K., Nabiaek T., The role of surgery in lung metastases, 10.1053/ejso.1999.0667
  57. Meyer Thomas, Merkel Susanne, Goehl Jonas, Hohenberger Werner, Surgical therapy for distant metastases of malignant melanoma, 10.1002/1097-0142(20001101)89:9<1983::aid-cncr15>3.3.co;2-j
  58. Fletcher William S., Pommier Rodney F., Lum Sharon, Wilmarth Thea J., Surgical treatment of metastatic melanoma, 10.1016/s0002-9610(98)00041-5
  59. Gorenstein Lyall A., Putnam Joe B., Natarajan Giri, Balch Charles A., Roth Jack A., Improved survival after resection of pulmonary metastases from malignant melanoma, 10.1016/0003-4975(91)91337-u
  60. Andrews S, Cancer Control, 13, 218 (2006)
  61. Hamm Caroline, Verma Shailendra, Petrella Teresa, Bak Kate, Charette Manya, Biochemotherapy for the treatment of metastatic malignant melanoma: A systematic review, 10.1016/j.ctrv.2007.10.003
  62. Mottaghy Felix M., Sunderkötter Cord, Schubert Roland, Wohlfart Petra, Blumstein Norbert M., Neumaier Bernd, Glatting Gerhard, Özdemir Cueneyt, Buck Andreas K., Scharfetter-Kochanek Karin, Reske Sven N., Direct comparison of [18F]FDG PET/CT with PET alone and with side-by-side PET and CT in patients with malignant melanoma, 10.1007/s00259-006-0358-1
Bibliographic reference Krug, Bruno ; Crott, Ralph ; Roch, Isabelle ; Lonneux, Max ; Beguin, Claire ; et. al. Cost-effectiveness analysis of FDG PET-CT in the management of pulmonary metastases from malignant melanoma. In: Acta Oncologica, Vol. 49, no. 2, p. 192-200 (2010)
Permanent URL http://hdl.handle.net/2078.1/29011