Financial Implication of Radioactive Iodine Therapy for Early-Stage Papillary Thyroid Cancer
Autor: | Emad Kandil, Zaid Al-Qurayshi, Daniah Bu Ali, Sudesh Srivastav |
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Rok vydání: | 2017 |
Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Cost-Benefit Analysis 030209 endocrinology & metabolism Papillary thyroid cancer Iodine Radioisotopes 03 medical and health sciences 0302 clinical medicine hemic and lymphatic diseases Internal medicine Prevalence medicine Humans In patient Thyroid Neoplasms Stage (cooking) Thyroid cancer Aged Proportional Hazards Models Retrospective Studies Gynecology business.industry Carcinoma General Medicine Middle Aged medicine.disease Carcinoma Papillary United States Treatment Outcome Thyroid Cancer Papillary 030220 oncology & carcinogenesis Female Radioactive iodine therapy Radioactive iodine business |
Zdroj: | Oncology. 93:122-126 |
ISSN: | 1423-0232 0030-2414 |
Popis: | Objective: The aim of this study was to evaluate disease-specific survival and cost related to radioactive iodine therapy (RAI) utilization in patients with early-stage papillary thyroid carcinoma (PTC). Methods: This was a retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database, 2004-2012. Results: A total of 38,374 patients with PTC were identified. Of those, 56.3% had adjuvant RAI. RAI administration was not associated with a survival advantage in patients with PTC stage I (hazard ratio [HR] 1.26, 95% confidence interval [CI] 0.11, 14.54; p = 0.85) or stage II (HR 0.50, 95% CI 0.05, 4.88; p = 0.55). Patients with PTC stage III who underwent adjuvant RAI had an improved survival (HR 0.30, 95% CI 0.10, 0.91; p = 0.033). In 2012, RAI was used in 45.5% of patients with stage I and in 71.4% of patients with stage II. The total expenditure on adjuvant RAI for PTC stage I throughout the study period was estimated to be USD 82.3 million with an annual average of USD 9.1 (±2.0) million/year. If the decline rate in the utilization of RAI continued, the model projected that the annual expenditure would decrease by USD 0.14 million/year. Conclusion: There is a high prevalence of adjuvant RAI utilization for early-stage PTC that is causing financial burden on the health system with no evidence of survival benefit. |
Databáze: | OpenAIRE |
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