Novel HPV Associated Oropharyngeal Squamous Cell Carcinoma Surveillance DNA Assay Cost Analysis.

Autor: Lin MG; University of Virginia School of Medicine, Charlottesville, Virginia, USA., Zhu A; Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia, USA., Read PW; Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia, USA., Garneau J; Department of Otolaryngology, University of Virginia, Charlottesville, Virginia, USA., McLaughlin C; Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia, USA.
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2023 Nov; Vol. 133 (11), pp. 3006-3012. Date of Electronic Publication: 2023 Apr 18.
DOI: 10.1002/lary.30701
Abstrakt: Objectives: We aim to propose a modified surveillance strategy using a novel blood assay that detects plasma circulating tumor-specific HPV DNA with reported 100% NPV and 94% PPV as the main method of detection to understand the cost implications of potentially avoiding routine imaging and surveillance visits at our institution.
Methods: We performed a retrospective chart review focusing on recurrences in p16+ patients with OPSCC and defined two surveillance strategies: "Strategy A", follow-up visits with flexible laryngoscopy (FL) plus regular imaging studies; "Strategy B", follow-up visits with FL plus regular NavDx assays and imaging used at the discretion of the physician(s) in cases of high clinical suspicion.
Results: Of the p16+ OPSCC patients (n = 214), 23 had confirmed recurrence (11%). Standard work-flow model determined 72 imaging studies and 2198 physical examinations with FL were needed to detect one recurrence. Potential individual patient cost reduction during surveillance was 42%.
Conclusion: Implementing NavDx for HPV + OPSCC surveillance would benefit patients by reducing costs and unnecessary diagnostic testing.
Level of Evidence: Step/Level 3 Laryngoscope, 133:3006-3012, 2023.
(© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)
Databáze: MEDLINE
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