The Cost-Effectiveness of Sentinel Lymph Node Mapping in High-Risk Endometrial Cancer

Lara C. Burg*, Robin J. Vermeulen, Ruud L. M. Bekkers, Roy F. P. M. Kruitwagen, Petra L. M. Zusterzeel

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Objectives. The aim was to evaluate the cost-effectiveness of sentinel lymph node (SLN) mapping in comparison to routine pelvic lymphadenectomy for lymph node assessment in patients with high-risk endometrial cancer (EC). Methods. A decision-analytic model was developed to compare SLN mapping with pelvic lymphadenectomy for guiding adjuvant therapy in patients with high-risk endometrioid and non-endometrioid EC, focusing on costs and health outcomes. The input data were obtained from systematic literature searches and expert consensus. Quality-adjusted life years (QALYs) was utilized as the measure of effectiveness. The model was constructed from a healthcare perspective, and the impact of uncertainty was evaluated through sensitivity analyses. Results. The base case analysis indicated that sentinel lymph node mapping is the dominant strategy for lymph node assessment in patients with high-risk endometrial cancer, as it was found to be both more effective and less costly than lymphadenectomy. The improved outcomes and reduced costs associated with SLN mapping primarily result from a decrease in the side effects related to lymph node assessment. Sensitivity analyses demonstrated that the outcome of the model was robust to variations in input values. Conclusion. SLN mapping is the most cost-effective strategy to determine the need for adjuvant therapy in patients with high-risk endometrioid and non-endometrioid endometrial cancer.
Original languageEnglish
Article number4240
Number of pages15
JournalCancers
Volume16
Issue number24
DOIs
Publication statusPublished - 1 Dec 2024

Keywords

  • endometrial cancer
  • high risk
  • sentinel lymph node mapping
  • lymphadenectomy
  • indocyanine green
  • cost-effectiveness analysis
  • LOWER-LIMB LYMPHEDEMA
  • QUALITY-OF-LIFE
  • LOWER-EXTREMITY LYMPHEDEMA
  • PARAAORTIC LYMPHADENECTOMY
  • RETROSPECTIVE ANALYSIS
  • COMPLICATIONS
  • WOMEN
  • BIOPSY
  • MANAGEMENT
  • TOXICITY

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