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Cost‐effectiveness of positron emission tomography‐CT in the evaluation of cancer of unknown primary of the head and neck
Author(s) -
Smith Kristine A.,
Dort Joseph C.,
Hall Stephen F.,
Rudmik Luke
Publication year - 2015
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.23830
Subject(s) - positron emission tomography , head and neck cancer , medicine , nuclear medicine , cost effectiveness , head and neck , computed tomography , population , radiology , medical physics , surgery , radiation therapy , risk analysis (engineering) , environmental health
Abstract Background Positron emission tomography (PET)‐CT is a useful diagnostic adjunct for cancer unknown primary (CUP) of the head and neck; however, the increased cost has not been justified with an economic evaluation in this patient population. Methods A decision tree analysis was performed from the perspective of the third party payer. Primary outcome was cost per life year gained ($/LYG). The 2 comparative groups were: (1) PET‐CT followed by panendoscopy versus (2) panendoscopy alone. Results The incremental cost‐effectiveness ratios for N1, N2, and N3 CUP were $369.83/LYG, $329.43/LYG, and $4900.28/LYG, respectively. The sensitivity analysis demonstrated a 96.8%, 97.1%, and 60.1% certainty that PET‐CT is cost‐effective for CUP with N1, N2, and N3 disease, respectively. Conclusion The use of PET‐CT in patients with N1 and N2 CUP is the cost‐effective choice. The cost‐effectiveness in N3 CUP is questionable and should be used on an individual case basis. © 2014 Wiley Periodicals, Inc. Head Neck 37: 1781–1787, 2015