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논문 기본 정보

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학술저널
저자정보
Hiroko Machida (Tokai University School of Medicine, Isehara, Japan) Mikio Mikami (Tokai University School of Medicine, Isehara, Japan) Koji Matsuo (Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Southern California, Los Angeles, CA, USA) Takahiro Higashi (N ational Cancer Center Japan, Institute for Cancer Control, Tokyo, Japan) Daisuke Aoki (International University of Health and Welfare Graduate School, Tokyo, Japan) Takayuki Enomoto (Niigata University School of Medicine, Niigata, Japan) Aikou Okamoto (Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan) Hidetaka Katabuchi (Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan) Satoru Nagase (Yamagata University Faculty of Medicine, Yamagata, Japan) Masaki Mandai (Graduate School of Medicine, Kyoto University, Kyoto, Japan) Nobuo Yaegashi (Department of Obstetrics and Gynecology, Tohoku University, Sendai, Japan) Wataru Yamagami (Keio University School of Medicine)
저널정보
대한부인종양학회 Journal of Gynecologic Oncology Journal of Gynecologic Oncology Vol.35 No.5
발행연도
2024.9
수록면
1 - 13 (13page)
DOI
https://doi.org/10.3802/jgo.2024.35.e61

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Objective: Hospital treatment volume affects survival in patients with endometrial cancer; notably, initial treatment at high-volume centers improves survival outcomes. Our study assessed the effect of hospital treatment volume on cost-effectiveness and survival outcomes in patients with endometrial cancer in Japan. Methods: A decision-analytic model was evaluated using the following variables and their impact on cost-effectiveness: 1) hospital treatment volume (low-, intermediate-, and high-volume centers) and 2) postoperative recurrent risk factors based on pathological findings (high- and intermediate-risk or low-risk). Data were obtained from the Japan Society of Obstetrics and Gynecology database, systematic literature searches, and the Japanese Diagnosis Procedure Combination database. Quality-adjusted life years (QALY) was used as a measure of effectiveness. The model was built from a public healthcare perspective and the impact of uncertainty was assessed using sensitivity analyses. Results: A base-case analysis showed that the incremental cost-effectiveness ratio at high-volume centers was below a willingness-to-pay (WTP) threshold of ¥5,000,000 with a maximum of ¥3,777,830/4.28 QALY for the high- and intermediate-risk group, and ¥2,316,695/4.57 QALY for the low-risk group. Treatment at the high-volume centers showed better efficiency and cost-effectiveness in both strategies compared to intermediate- or low-volume centers. Sensitivity analyses showed that the model outcome was robust to changes in input values. With the WTP threshold, treatment at high-volume centers remained cost-effective in at least 73.6% and 78.2% of iterations for high- and intermediate-risk, and low-risk groups, respectively. Conclusion: Treatment at high-volume centers is the most cost-effective strategy for guiding treatment centralization in patients with endometrial cancer.
#Endometrial Cancer #Cost-Effectiveness Analysis #Hospital #Survival #Quality-Adjusted Life Years

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