TY - JOUR
T1 - Real-world costs and dynamics of surveillance in patients who underwent surgery for low-risk branch duct intraductal papillary mucinous neoplasms
AU - Tamburrino, Domenico
AU - Cortesi, Paolo
AU - Facchetti, Rita
AU - de Pretis, Nicolò
AU - Pérez-Cuadrado-Robles, Enrique
AU - Uribarri-Gonzalez, Laura
AU - Ateeb, Zeeshan
AU - Belfiori, Giulio
AU - Arcidiacono, Paolo Giorgio
AU - Mantovani, Lorenzo Giovanni
AU - Del Chiaro, Marco
AU - Laukkarinen, Johanna
AU - Falconi, Massimo
AU - Crippa, Stefano
AU - Capurso, Gabriele
N1 - Funding Information:
We thank “Pancreas 2000” program for providing data from multecenter Institutions. Stefano Crippa was supported from “Fondazione Nadia Valsecchi”.
Funding Information:
Dr Del Chiaro received a research grant from Haemonetics, Inc and is co-PI of a Boston Scientific sponsored study on the use of intra-operative pancreatoscopy in IPMN's patients.
Publisher Copyright:
© 2022
PY - 2023/1
Y1 - 2023/1
N2 - Surveillance costs and appropriateness of surgery of “low-risk” BD-IPMNs are relevant issues. In this study we evaluated the rate of correct indication for pancreatectomy defined as high grade dysplasia (HGD) at histology in 961 patients who underwent surveillance for a median of 5.1 years. Undertreatment and overtreatment were defined as invasive cancer and low grade dysplasia (LGD) at histology, respectively. Of the 66 patients (6.9%) who were operated, only 16 (23.8%) had a HGD while 40 (59.7%) had a LGD and 10 (14.9%) an invasive cancer, without differences regarding timing of surgery. The mean surveillance cost was € 194.9 ± 107.6 per patient-year, with a median cost of € 277.1 ± 148.2 in the correct surgery group compared with € 222.7 ± 111.6 and € 197 ± 102.7 in the overtreatment and undertreatment groups. The surveillance mean cost from diagnosis to surgery was € 854.8. Rate of appropriate surgery in BD-IPMNs under surveillance is low.
AB - Surveillance costs and appropriateness of surgery of “low-risk” BD-IPMNs are relevant issues. In this study we evaluated the rate of correct indication for pancreatectomy defined as high grade dysplasia (HGD) at histology in 961 patients who underwent surveillance for a median of 5.1 years. Undertreatment and overtreatment were defined as invasive cancer and low grade dysplasia (LGD) at histology, respectively. Of the 66 patients (6.9%) who were operated, only 16 (23.8%) had a HGD while 40 (59.7%) had a LGD and 10 (14.9%) an invasive cancer, without differences regarding timing of surgery. The mean surveillance cost was € 194.9 ± 107.6 per patient-year, with a median cost of € 277.1 ± 148.2 in the correct surgery group compared with € 222.7 ± 111.6 and € 197 ± 102.7 in the overtreatment and undertreatment groups. The surveillance mean cost from diagnosis to surgery was € 854.8. Rate of appropriate surgery in BD-IPMNs under surveillance is low.
KW - Branch-duct IPNM
KW - Cost-effectiveness
KW - EUS
KW - Intraductal papillary mucinous neoplasm
KW - Pancreas
KW - Pancreatic cystic neoplasm
KW - Pancreatic surgery
U2 - 10.1016/j.ejso.2022.08.033
DO - 10.1016/j.ejso.2022.08.033
M3 - Article
C2 - 36085119
AN - SCOPUS:85137692837
SN - 0748-7983
VL - 49
SP - 137
EP - 141
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
IS - 1
ER -
