The authors have no funding, financial relationships, or conflicts of interest to disclose.
Head and Neck
A cost-effectiveness analysis of positron emission tomography-computed tomography surveillance versus up-front neck dissection for management of the neck for N2 disease after chemoradiotherapy†
Article first published online: 17 JAN 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 2, pages 311–314, February 2012
How to Cite
Rabalais, A., Walvekar, R. R., Johnson, J. T. and Smith, K. J. (2012), A cost-effectiveness analysis of positron emission tomography-computed tomography surveillance versus up-front neck dissection for management of the neck for N2 disease after chemoradiotherapy. The Laryngoscope, 122: 311–314. doi: 10.1002/lary.22464
- Issue published online: 23 JAN 2012
- Article first published online: 17 JAN 2012
- Manuscript Accepted: 2 AUG 2011
- Manuscript Revised: 29 JUL 2011
- Manuscript Received: 12 APR 2011
- Cost-effective analysis;
- positron emission tomography-computed tomography;
- computed tomography;
- neck dissection;
- salvage neck dissection;
- elective neck dissection;
- Level of Evidence: 2b
To study the cost effectiveness of positron emission tomography-computerized tomography (PET-CT) scanning in the management of the neck after chemoradiotherapy (CRT).
Cost effectiveness and decision analysis model.
A cost-effectiveness analysis comparing up-front neck dissection to serial PET-CT imaging in a hypothetical clinical scenario of debate. A patient with an oropharygeal cancer with pretreatment N2 disease having a complete response was considered. Standardized costs were obtained using national databases. A literature review in PubMed was performed to obtain information on incidence, probabilities, and range for various clinical events in the algorithm.
PET-CT strategy costs an average of $14,492 per patient. Neck dissection had a 0.6% greater efficacy in controlling neck disease with a $22,433 incremental cost.
Our results strongly support the use of PET-CT imaging as the more cost-effective strategy for surveillance of neck after completion of definitive CRT compared to up-front neck dissection.