Evidence map›Paper›PMID 33536126›Full record

ArticleGynecologic oncology2021

Cost-effectiveness of laparoscopic disease assessment in patients with newly diagnosed advanced ovarian cancer.

Ross F Harrison, Scott B Cantor, Charlotte C Sun, Mariana Villanueva, Shannon N Westin, Nicole D Fleming, Iakovos Toumazis, Anil K Sood, Karen H Lu, Larissa A Meyer

Open access · greenAbstract read
In one paragraph

Article in Gynecologic oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 20% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.

  1. ISUOG/ESGO Consensus Statement on ultrasound-guided biopsy in gynecological oncology.Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology · 2025
    Guideline
  2. Pooled it
  3. Review
  4. Review
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

10 authors at 1 institution in 1 country.

Ross F HarrisonDepartment of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Unit 1362, Houston, TX 77030, United States of America.
Scott B CantorDepartment of Health Services Research, Cancer Prevention and Population Sciences Division, The University of Texas MD Anderson Cancer Center, 1400 Pressler St. FCT 9.5000, Houston, TX 77030, United States of America.
Charlotte C SunDepartment of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Unit 1362, Houston, TX 77030, United States of America.
Mariana VillanuevaDepartment of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Unit 1362, Houston, TX 77030, United States of America.
Shannon N WestinDepartment of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Unit 1362, Houston, TX 77030, United States of America.
Nicole D FlemingDepartment of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Unit 1362, Houston, TX 77030, United States of America.
Iakovos ToumazisDepartment of Health Services Research, Cancer Prevention and Population Sciences Division, The University of Texas MD Anderson Cancer Center, 1400 Pressler St. FCT 9.5000, Houston, TX 77030, United States of America.
Anil K SoodDepartment of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Unit 1362, Houston, TX 77030, United States of America.
Karen H LuDepartment of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Unit 1362, Houston, TX 77030, United States of America.
Larissa A MeyerDepartment of Gynecologic Oncology and Reproductive Medicine, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1155 Pressler Street, Unit 1362, Houston, TX 77030, United States of America; Department of Health Services Research, Cancer Prevention and Population Sciences Division, The University of Texas MD Anderson Cancer Center, 1400 Pressler St. FCT 9.5000, Houston, TX 77030, United States of America. Electronic address: lmeyer@mdanderson.org.
The University of Texas MD Anderson Cancer Center · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
Training of Academic Gynecologic OncologistsT32CA101642 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI ANIL K SOOD, Kathleen Schmeler · 2005 to 2026
$9.2M
U.T. M. D. Anderson Cancer Center SPORE in Ovarian CancerP50CA217685 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI BAST, ROBERT C, SOOD, ANIL K · 2017 to 2021
$7.9M
Health Services Career Development: Improving Medical Decisions in Ovarian CancerK07CA201013 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI MEYER, LARISSA ALEJANDRA · 2016 to 2020
$853k
NCI NIH HHS K07 CA201013NCI NIH HHS P30 CA016672NCI NIH HHS P50 CA217685NCI NIH HHS T32 CA101642
6 · The paper itself

Abstract

objectiveTo determine if laparoscopy is a cost-effective way to assess disease resectability in patients with newly diagnosed advanced ovarian cancer.

methodsA cost-effectiveness analysis from a health care payer perspective was performed comparing two strategies: (1) a standard evaluation strategy, where a conventional approach to treatment planning was used to assign patients to either primary cytoreduction (PCS) or neoadjuvant chemotherapy with interval cytoreduction (NACT), and (2) a laparoscopy strategy, where patients considered candidates for PCS would undergo laparoscopy to triage between PCS or NACT based on the laparoscopy-predicted likelihood of complete gross resection. A microsimulation model was developed that included diagnostic work-up, surgical and adjuvant treatment, perioperative complications, and progression-free survival (PFS). Model parameters were derived from the literature and our published data. Effectiveness was defined in quality-adjusted PFS years. Results were tested with deterministic and probabilistic sensitivity analysis (PSA). The willingness-to-pay (WTP) threshold was set at $50,000 per year of quality-adjusted PFS.

resultsThe laparoscopy strategy led to additional costs (average additional cost $7034) but was also more effective (average 4.1 months of additional quality-adjusted PFS). The incremental cost-effectiveness ratio (ICER) of laparoscopy was $20,376 per additional year of quality-adjusted PFS. The laparoscopy strategy remained cost-effective even as the cost added by laparoscopy increased. The benefit of laparoscopy was influenced by mitigation of serious complications and their associated costs. The laparoscopy strategy was cost-effective across a range of WTP thresholds.

conclusionsPerforming laparoscopy is a cost-effective way to improve primary treatment planning for patients with untreated advanced ovarian cancer.

Indexed as

Cost-Benefit AnalysisCytoreduction Surgical ProceduresFemaleHumansLaparoscopyModels, EconomicModels, StatisticalOvarian NeoplasmsUnited StatesCost-effectivenessMinimally invasive surgeryOvarian cancer

Identifiers

PMID33536126
PMCPMC8247119
OpenAlexW3127369901

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.