Evidence map›Paper›PMID 31140003›Full record

Observational studySurgical endoscopy2020

Stage- and age-adjusted cost-effectiveness analysis of laparoscopic surgery in rectal cancer.

Javier Mar, Ane Anton-Ladislao, Oliver Ibarrondo, Arantzazu Arrospide, Santiago Lázaro-Aramburu, Nerea Gonzalez, Marisa Bare, Antonio Escobar, Maximino Redondo, José M Quintana and 1 more

Registry-linked trialAbstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Surgical endoscopy, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02488161 (Risk Factors of Adverse Outcomes at Short and Medium Term, and Development of Predictive Models, in Patients With Colorectal Cancer. IRYSS-coordinated Multicenter Study), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.2field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02488161 completednot on this map

Risk Factors of Adverse Outcomes at Short and Medium Term, and Development of Predictive Models, in Patients With Colorectal Cancer. IRYSS-coordinated Multicenter Study

TypeobservationalSponsorHospital Galdakao-UsansoloRan2010 to 2015Enrolled2,600ConditionsColorectal CancerArmsNo intervention
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 2 countries.

Javier MarGipuzkoa Primary Care-Integrated Healthcare Organisation Research Unit, Hospital Alto Deba, Mondragón, Spain. javier.marmedina@osakidetza.eus.ORCID 0000-0002-9455-4869
Ane Anton-LadislaoResearch Unit, Hospital Galdakao-Usansolo, Galdakao, Spain.
Oliver IbarrondoGipuzkoa Primary Care-Integrated Healthcare Organisation Research Unit, Hospital Alto Deba, Mondragón, Spain.
Arantzazu ArrospideGipuzkoa Primary Care-Integrated Healthcare Organisation Research Unit, Hospital Alto Deba, Mondragón, Spain.
Santiago Lázaro-AramburuGeneral Surgery Department, Hospital Basurto, Bilbao, Spain.
Nerea GonzalezResearch Unit, Hospital Galdakao-Usansolo, Galdakao, Spain.
Marisa BareClinical Epidemiology Unit, Corporacio Parc Tauli, Barcelona, Spain.
Antonio EscobarResearch Unit, Hospital Basurto, Bilbao, Spain.
Maximino RedondoResearch Unit, Hospital Costa del Sol, Malaga, Spain.
José M QuintanaResearch Unit, Hospital Galdakao-Usansolo, Galdakao, Spain.
REDISSEC-CARESS/CCR group
Hospital Alto Deba · ESHospital de Basurto · ESSpanish Clinical Research Network · ESHospital Costa del Sol · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIt has been argued that laparoscopy should be a standard treatment in rectal cancer due to its greater technical complexity. The objective of this study was to conduct a cost-effectiveness analysis to compare laparoscopy with open surgery for rectal cancer adjusting for age and clinical stage.

methodsA real-world prospective cost-effectiveness cohort study was conducted with data on costs and effectiveness at individual patient level. A "genetic matching" algorithm was used to correct for selection bias. After balancing the sample groups, combined multivariate analysis of total costs and quality-adjusted life years (QALYs) was performed using seemingly unrelated regression (SUR) models. These models were first constructed without interactions and, subsequently, effects of any age-stage interaction were analyzed.

resultsThe sample included 601 patients (400 by laparoscopy and 201 by open surgery). Crude cost-effectiveness analysis indicated that overall laparoscopy was cheaper and associated with higher QALYs. The SUR models without interactions showed that while laparoscopy remained dominant, the incremental effectiveness decreased to the point that it offered no statistically significant benefits over open surgery. In the subgroup analysis, at advanced stages of the disease, although none of the coefficients were significant, the mean incremental effectiveness (QALYs value) for laparoscopy was positive in younger patients and negative in older patients. Further, for advanced stages, the mean cost of open surgery was lower in both age subgroups but differences did not reach statistical significance. In early stages, laparoscopy cost was significantly lower in the subgroup younger than 70 and higher in the older subgroup.

conclusionsThe cost-effectiveness of laparoscopy in surgery for rectal cancer justifies this being the standard surgical procedure in young patients and those at initial stages. The choice of procedure should be discussed with patients who are older and/or in advanced stages of the disease. Trial registration ClinicalTrials.gov Identifier: NCT02488161.

Indexed as

Cost-Benefit AnalysisAdultAgedAge FactorsFemaleHumansLaparoscopyMaleMiddle AgedNeoplasm StagingProspective StudiesQuality-Adjusted Life YearsRectal NeoplasmsTreatment OutcomeAgeCost-effectivenessLaparoscopyOpen surgeryRectal cancerStage

Identifiers

PMID31140003
OpenAlexW2947944859

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.