{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:42:14Z","timestamp":1787611334130,"version":"build-2736575974"},"reference-count":60,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to assess the incremental cost per quality\u2010adjusted\u2010life\u2010year (QALY) gained in treating patients with early oral squamous cell carcinoma (OSCC) using sentinel lymph node biopsy (SLNB) guided neck dissection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Markov model was created to simulate disease\u2010free survival, recurrence, and overall survival in a hypothetical cohort of patients with early OSCC in India. Three groups were assessed: Group I\u2014SLNB\u2010guided neck dissection, Group II\u2014elective neck dissection (END) alone, and Group III\u2014END with frozen section (FS). Costs and QALY were assessed using a payer's perspective, lifetime horizon, and 3% discount, and incremental cost utility ratios (ICUR) were computed. Interventions with ICUR less than one\u2010time gross domestic product (GDP) per capita were considered cost\u2010effective. Both one\u2010way and probabilistic\u2010sensitivity analyses were conducted to examine model uncertainty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In comparison to Group II and Group III, Group I incurs additional costs of INR 5564 (US$ 67) and INR 2507 (US$ 30) per patient, respectively, and results in an incremental gain of 0.31 and 0.33 additional QALYs, respectively, over a lifetime horizon. The ICURs for Group I versus Group II and Group III are INR 8088 (US$ 97) and INR 16,709 (US$ 200), respectively. At a threshold of one\u2010time per\u2010capita GDP, SLNB demonstrates a 94% probability of being cost\u2010effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SLNB\u2010guided neck dissection is a cost\u2010effective strategy for management of early OSCC in India. Our findings support inclusion of SLNB\u2010guided neck dissection in the Indian Government's insurance program.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71571","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T04:08:02Z","timestamp":1770350882000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Sentinel Lymph\u2010Node Biopsy Guided Neck Dissection Versus Elective Neck Dissection in the Management of Early\u2010Stage Oral Cancer\u2014A Cost\u2010Utility Analysis"],"prefix":"10.1002","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1957-3338","authenticated-orcid":false,"given":"Shivakumar","family":"Thiagarajan","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology Tata Memorial Hospital, Parel, Homi Bhabha National Institute  Mumbai India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta","family":"Sharda","sequence":"additional","affiliation":[{"name":"Department of Community Medicine &amp; School of Public Health Post Graduate Institute of Medical Education &amp; Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yashika","family":"Chugh","sequence":"additional","affiliation":[{"name":"Department of Community Medicine &amp; School of Public Health Post Graduate Institute of Medical Education &amp; Research  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Government Medical College and Hospital  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. 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