Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery

Object: Low-field intraoperative magnetic resonance (LF-iMR) has demonstrated a slight increase in the extent of resection of intra-axial tumors while preserving patient`s neurological outcomes. However, whether this improvement is cost-effective or not is still matter of controversy. In this clinic...

ver descrição completa

Detalhes bibliográficos
Autores: García García, Sergio, García Lorenzo, Borja, Roldán Ramos, Pedro, González Sánchez, José Juan, Culebras, Diego, Restovic, Gabriela, Alcover, Estanis, Pons, Imma, Torales, Jorge, Reyes, Luis, Sampietro Colom, Laura, Enseñat Nora, Joaquim
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Recursos:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/175859
Acesso em linha:https://hdl.handle.net/2445/175859
Access Level:acceso abierto
Palavra-chave:Glioma
Ressonància magnètica
Gliomas
Magnetic resonance
id ES_2e6eec4a2eea51a309d72c6ed74fb344
oai_identifier_str oai:recercat.cat:2445/175859
network_acronym_str ES
network_name_str España
repository_id_str
spelling Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma SurgeryGarcía García, SergioGarcía Lorenzo, BorjaRoldán Ramos, PedroGonzález Sánchez, José JuanCulebras, DiegoRestovic, GabrielaAlcover, EstanisPons, ImmaTorales, JorgeReyes, LuisSampietro Colom, LauraEnseñat Nora, JoaquimGliomaRessonància magnèticaGliomasMagnetic resonanceObject: Low-field intraoperative magnetic resonance (LF-iMR) has demonstrated a slight increase in the extent of resection of intra-axial tumors while preserving patient`s neurological outcomes. However, whether this improvement is cost-effective or not is still matter of controversy. In this clinical investigation we sought to evaluate the cost-effectiveness of the implementation of a LF-iMR in glioma surgery. Methods: Patients undergoing LF-iMR guided glioma surgery with gross total resection (GTR) intention were prospectively collected and compared to an historical cohort operated without this technology. Socio-demographic and clinical variables (pre and postoperative KPS; histopathological classification; Extent of resection; postoperative complications; need of re-intervention within the first year and 1-year postoperative survival) were collected and analyzed. Effectiveness variables were assessed in both groups: Postoperative Karnofsky performance status scale (pKPS); overall survival (OS); Progression-free survival (PFS); and a variable accounting for the number of patients with a greater than subtotal resection and same or higher postoperative KPS (R-KPS). All preoperative, procedural and postoperative costs linked to the treatment were considered for the cost-effectiveness analysis (diagnostic procedures, prosthesis, operating time, hospitalization, consumables, LF-iMR device, etc). Deterministic and probabilistic simulations were conducted to evaluate the consistency of our analysis. Results: 50 patients were operated with LF-iMR assistance, while 146 belonged to the control group. GTR rate, pKPS, R-KPS, PFS, and 1-year OS were respectively 13,8% (not significative), 7 points (p < 0.05), 17% (p < 0.05), 38 days (p < 0.05), and 3.7% (not significative) higher in the intervention group. Cost-effectiveness analysis showed a mean incremental cost per patient of 789 in the intervention group. Incremental cost-effectiveness ratios were 111 per additional point of pKPS, 21 per additional day free of progression, and 46 per additional percentage point of R-KPS. Conclusion: Glioma patients operated under LF-iMR guidance experience a better functional outcome, higher resection rates, less complications, better PFS rates but similar life expectancy compared to conventional techniques. In terms of efficiency, LF-iMR is very close to be a dominant technology in terms of R-KPS, PFS and pKPS.Frontiers Media2021202120202021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion11 p.application/pdfhttps://hdl.handle.net/2445/175859Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3389/fonc.2020.586679Frontiers In Oncology, 2020, vol. 10https://doi.org/10.3389/fonc.2020.586679cc-by (c) García García, Sergio et al., 2020http://creativecommons.org/licenses/by/3.0/esinfo:eu-repo/semantics/openAccessoai:recercat.cat:2445/1758592026-05-29T05:05:01Z
dc.title.none.fl_str_mv Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery
title Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery
spellingShingle Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery
García García, Sergio
Glioma
Ressonància magnètica
Gliomas
Magnetic resonance
title_short Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery
title_full Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery
title_fullStr Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery
title_full_unstemmed Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery
title_sort Cost-Effectiveness of Low-Field Intraoperative Magnetic Resonance in Glioma Surgery
dc.creator.none.fl_str_mv García García, Sergio
García Lorenzo, Borja
Roldán Ramos, Pedro
González Sánchez, José Juan
Culebras, Diego
Restovic, Gabriela
Alcover, Estanis
Pons, Imma
Torales, Jorge
Reyes, Luis
Sampietro Colom, Laura
Enseñat Nora, Joaquim
author García García, Sergio
author_facet García García, Sergio
García Lorenzo, Borja
Roldán Ramos, Pedro
González Sánchez, José Juan
Culebras, Diego
Restovic, Gabriela
Alcover, Estanis
Pons, Imma
Torales, Jorge
Reyes, Luis
Sampietro Colom, Laura
Enseñat Nora, Joaquim
author_role author
author2 García Lorenzo, Borja
Roldán Ramos, Pedro
González Sánchez, José Juan
Culebras, Diego
Restovic, Gabriela
Alcover, Estanis
Pons, Imma
Torales, Jorge
Reyes, Luis
Sampietro Colom, Laura
Enseñat Nora, Joaquim
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Glioma
Ressonància magnètica
Gliomas
Magnetic resonance
topic Glioma
Ressonància magnètica
Gliomas
Magnetic resonance
description Object: Low-field intraoperative magnetic resonance (LF-iMR) has demonstrated a slight increase in the extent of resection of intra-axial tumors while preserving patient`s neurological outcomes. However, whether this improvement is cost-effective or not is still matter of controversy. In this clinical investigation we sought to evaluate the cost-effectiveness of the implementation of a LF-iMR in glioma surgery. Methods: Patients undergoing LF-iMR guided glioma surgery with gross total resection (GTR) intention were prospectively collected and compared to an historical cohort operated without this technology. Socio-demographic and clinical variables (pre and postoperative KPS; histopathological classification; Extent of resection; postoperative complications; need of re-intervention within the first year and 1-year postoperative survival) were collected and analyzed. Effectiveness variables were assessed in both groups: Postoperative Karnofsky performance status scale (pKPS); overall survival (OS); Progression-free survival (PFS); and a variable accounting for the number of patients with a greater than subtotal resection and same or higher postoperative KPS (R-KPS). All preoperative, procedural and postoperative costs linked to the treatment were considered for the cost-effectiveness analysis (diagnostic procedures, prosthesis, operating time, hospitalization, consumables, LF-iMR device, etc). Deterministic and probabilistic simulations were conducted to evaluate the consistency of our analysis. Results: 50 patients were operated with LF-iMR assistance, while 146 belonged to the control group. GTR rate, pKPS, R-KPS, PFS, and 1-year OS were respectively 13,8% (not significative), 7 points (p < 0.05), 17% (p < 0.05), 38 days (p < 0.05), and 3.7% (not significative) higher in the intervention group. Cost-effectiveness analysis showed a mean incremental cost per patient of 789 in the intervention group. Incremental cost-effectiveness ratios were 111 per additional point of pKPS, 21 per additional day free of progression, and 46 per additional percentage point of R-KPS. Conclusion: Glioma patients operated under LF-iMR guidance experience a better functional outcome, higher resection rates, less complications, better PFS rates but similar life expectancy compared to conventional techniques. In terms of efficiency, LF-iMR is very close to be a dominant technology in terms of R-KPS, PFS and pKPS.
publishDate 2020
dc.date.none.fl_str_mv 2020
2021
2021
2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://hdl.handle.net/2445/175859
url https://hdl.handle.net/2445/175859
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3389/fonc.2020.586679
Frontiers In Oncology, 2020, vol. 10
https://doi.org/10.3389/fonc.2020.586679
dc.rights.none.fl_str_mv cc-by (c) García García, Sergio et al., 2020
http://creativecommons.org/licenses/by/3.0/es
info:eu-repo/semantics/openAccess
rights_invalid_str_mv cc-by (c) García García, Sergio et al., 2020
http://creativecommons.org/licenses/by/3.0/es
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv 11 p.
application/pdf
dc.publisher.none.fl_str_mv Frontiers Media
publisher.none.fl_str_mv Frontiers Media
dc.source.none.fl_str_mv Articles publicats en revistes (Cirurgia i Especialitats Medicoquirúrgiques)
reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869405404094529536
score 15,812429

Registos relacionados