Journal article
Total Thyroidectomy Versus Lobectomy in Small Nodules Suspicious for Papillary Thyroid Cancer: Cost-Effectiveness Analysis
The Laryngoscope, Vol.130(12), pp.2922-2926
12/2020
DOI: 10.1002/lary.28634
PMID: 32239764
Abstract
Recent American Thyroid Association Guidelines recommend either near-total/total thyroidectomy or lobectomy for patients with a thyroid nodule suspicious for papillary thyroid cancer (PTC) on fine-needle aspiration (FNA) biopsy (Bethesda V). In this analysis, we aim to assess the cost-effectiveness of lobectomy in comparison to total thyroidectomy.
Cost-effectiveness analysis.
A Markov model cost-effectiveness analysis was performed for a base case followed for 20 years postoperatively. Cost and probabilities data were retrieved from the current literature. Effectiveness was represented by quality-adjusted life year (QALY).
Total thyroidectomy protocol produced an incremental cost of $2,681.36 and incremental effectiveness of -0.24 QALY as compared to lobectomy protocol (incremental cost-effectiveness ratio [ICER] = -$11,188.85/QALY). Sensitivity analysis demonstrated that total thyroidectomy becomes a cost-effective strategy only if the risk of stages III and IV PTC is 82.4% among patients with suspicious PTC on preoperative FNA. Lobectomy is cost effective and preferred over total thyroidectomy as long as lobectomy complications are less than 50%.
Total thyroidectomy is not just cost prohibitive but also associated with a lower effectiveness compared to lobectomy.
2c Laryngoscope, 2020.
Details
- Title: Subtitle
- Total Thyroidectomy Versus Lobectomy in Small Nodules Suspicious for Papillary Thyroid Cancer: Cost-Effectiveness Analysis
- Creators
- Zaid Al-Qurayshi - University of IowaMahmoud Farag - Tulane UniversityMohamed A Shama - Massachusetts Eye and Ear InfirmaryKareem Ibraheem - Tulane UniversityGregory W Randolph - Massachusetts Eye and Ear InfirmaryEmad Kandil - Tulane University
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.130(12), pp.2922-2926
- DOI
- 10.1002/lary.28634
- PMID
- 32239764
- ISSN
- 0023-852X
- eISSN
- 1531-4995
- Language
- English
- Date published
- 12/2020
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984702941202771
Metrics
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