Journal of Clinical Oncology, 2006 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 24, No 18S (June 20 Supplement), 2006: 6127
© 2006 American Society of Clinical Oncology

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Abstract

Laparoscopic treatment of endometrial cancer: A cost-effectiveness analysis

University of North Carolina, Chapel Hill, NC

6127

Background: Endometrial cancer has traditionally been staged using an open abdominal incision. Laparoscopic staging offers the benefits of a minimally invasive approach and may also be economically advantageous. Methods: A decision model was developed to determine the cost-effectiveness of laparoscopy versus laparotomy for surgical staging of a hypothetical cohort of women, aged 35 to 80 years, with early-stage endometrial cancer. The analysis was performed from a societal perspective with a time horizon of six weeks. The primary outcome was cost-effectiveness, measured as cost per complete staging procedure. Parameters in the decision model included rates of mortality, intraoperative complications (bowel, bladder, or vascular injury and intraoperative hemorrhage), deep venous thrombosis (DVT), blood transfusion, and length of hospitalization. Assumptions included that laparoscopy and laparotomy were equally effective for staging, and that the length of hospitalization was one day for laparoscopy versus three days for laparotomy. Probability estimates were obtained from a review of the medical literature and from institutional data. Results: The cost for laparoscopic staging per subject was $14,616 compared to $16,184 for laparotomy. Thus, the incremental cost-effectiveness ratio (ICER) was $1,568 per complete staging procedure, and laparoscopy was more cost-effective than laparotomy. Based on one-way sensitivity analyses, the factor that had the greatest influence on the model was length of hospital stay after laparotomy. The ICER was insensitive to changes in the rates of mortality, intraoperative complications, and blood transfusions. Conclusions: Laparoscopic surgery for endometrial cancer is a cost-effective alternative to laparotomy, primarily because it reduces the length of the postoperative hospitalization.

No significant financial relationships to disclose.

Abstract presentation from the 2006 ASCO Annual Meeting