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Cost‐effectiveness of selective neck dissection versus modified radical neck dissection for treating metastases in patients with oral cavity cancer: A modelling study
Author(s) -
Govers Tim M.,
Patel Sejal,
Takes Robert P.,
Merkx Thijs,
Rovers Maroeska,
Grutters Janneke
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.23833
Subject(s) - neck dissection , medicine , dissection (medical) , head and neck cancer , quality of life (healthcare) , surgery , head and neck squamous cell carcinoma , basal cell , cancer , radiation therapy , nursing
Background Choosing between a more or less extensive neck dissection implies a tradeoff between survival, quality of life, and costs. The purpose of this study was to determine if selective neck dissection (level I–III or I–IV) is cost‐effective compared with modified radical neck dissection (level I–V) in patients with cT 1–2 oral squamous cell carcinoma (OSCC) with singular nodal disease confined to level I or II. Methods A decision‐analytic model was developed to model quality‐adjusted life years (QALYs) and costs over a lifetime horizon, based on literature. Results The selective neck dissection strategy resulted in an expected health loss of 0.06 QALY and savings of €1351 per patient compared to modified radical neck dissection. The results were sensitive to differences in regional failure probabilities between the strategies. Conclusion With the evidence used in this model, selective neck dissection was not cost‐effective compared to modified radical neck dissection. Prospective research on regional failure is needed to provide optimal treatment for patients with OSCC. © 2015 Wiley Periodicals, Inc. Head Neck 37: 1762–1768, 2015