Evidence map›Paper›PMID 34711226›Full record

ArticleBMC health services research2021

Cost-utility of two minimally-invasive surgical techniques for operable oropharyngeal cancer: transoral robotic surgery versus transoral laser microsurgery.

Enea Parimbelli, Federico Soldati, Lorry Duchoud, Gian Luca Armas, John de Almeida, Martina Broglie, Silvana Quaglini, Christian Simon

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
2.9field-weighted citation impact, top 8% 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

13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 22 citations in OpenAlex.

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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

8 authors at 5 institutions in 3 countries.

Enea Parimbelli *Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.
Federico Soldati *Department of Otolaryngology - Head and Neck Surgery, Centre Universitaire Hospitalier Vaudois, University of Lausanne, Lausanne, Switzerland.
Lorry DuchoudDepartment of Otolaryngology - Head and Neck Surgery, Centre Universitaire Hospitalier Vaudois, University of Lausanne, Lausanne, Switzerland.
Gian Luca ArmasDepartment of Otolaryngology - Head and Neck Surgery, Centre Universitaire Hospitalier Vaudois, University of Lausanne, Lausanne, Switzerland.
John de AlmeidaDepartment of Otolaryngology-Head and Neck Surgery, Princess Margaret Cancer Centre- University Health Network, University of Toronto, Toronto, Canada.
Martina BroglieDepartment of Otolaryngology - Head and Neck Surgery, Universitätsspital Zürich, University Hospital Zurich, Zürich, Switzerland.
Silvana Quaglini *Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy.
Christian Simon *Department of Otolaryngology - Head and Neck Surgery, Centre Universitaire Hospitalier Vaudois, University of Lausanne, Lausanne, Switzerland. Christian.Simon@chuv.ch.
University Hospital of Lausanne · CHUniversity of Lausanne · CHUniversity of Pavia · ITUniversity Hospital of Zurich · CHUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn the past few decades, a re-evaluation of treatment paradigms of head and neck cancers with a desire to spare patients the treatment-related toxicities of open surgery, has led to the development of new minimally invasive surgical techniques to improve outcomes. Besides Transoral Laser Microsurgery (TLM), a new robotic surgical technique namely Transoral Robotic Surgery (TORS) emerged for the first time as one of the two most prominent and widely used minimally invasive surgical approaches particularly for the treatment of oropharyngeal cancer, a sub-entity of head and neck cancers. Recent population-level data suggest equivalent tumor control, but different total costs, and need for adjuvant chemoradiation. A comparative analysis of these two techniques is therefore warranted from the cost-utility (C/U) point of view.

methodsA cost-utility analysis for comparing TORS and TLM was performed using a decision-analytical model. The analyses adopted the perspective of a Swiss hospital. Two tertiary referral centers in Lausanne and Zurich provided data for model quantificantion.

resultsIn the base case analysis TLM dominates TORS. This advantage remains robust, even if the costs for TORS reduce by up to 25%. TORS begins to dominate TLM, if less than 59,7% patients require adjuvant treatment, whereby in an interval between 55 and 62% cost effectiveness of TORS is sensitive to the prescription of adjuvant chemoradiation therapy (CRT). Exceeding 29% of TLM patients requiring a revision of surgical margins renders TORS more cost-effective.

conclusionNon-robotic endoscopic surgery (TLM) is more cost-effective than robotic endoscopic surgery (TORS) for the treatment of oropharyngeal cancers. However, this advantage is sensitive to various parameters, i.e.to the number of re-operations and adjuvant treatment.

Indexed as

Carcinoma, Squamous CellOropharyngeal NeoplasmsRobotic Surgical ProceduresHumansLasersMicrosurgeryTreatment OutcomeCost-utilityHead and neck cancerOropharyngeal cancerTransoral laser microsurgeryTransoral robotic surgery

Identifiers

PMID34711226
PMCPMC8555235
OpenAlexW3209600398

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.