{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T18:46:21Z","timestamp":1772045181000,"version":"3.50.1"},"reference-count":58,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T00:00:00Z","timestamp":1485216000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,5,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The objective of this study was to determine the cost\u2010effectiveness of radical hysterectomy (RH) and sentinel lymph node biopsy (SLNB) for the management of early\u2010stage cervical cancer (stage IA2\u2010IB1).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>A simple decision tree model was developed to follow a simulated cohort of patients with early\u2010stage cervical cancer treated with RH and 1 of 3 lymph node assessment strategies: systematic pelvic lymph node dissection (PLND), SLNB using technetium 99 (Tc99) and blue dye, and SLNB using Tc99 only. SLNB using indocyanine green (ICG) was used as an exploratory strategy. Relevant studies were identified to extract the probability data and utility parameters and to estimate quality\u2010adjusted life\u2010years (QALYs) and absolute life\u2010years (ALYs). Only direct medical costs were modeled, and the time horizon for the study was 5 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>SLNB using Tc99 and blue dye cost $21,089 and yielded 4.54 QALYs and 4.90 ALYs. PLND cost $22,353 and yielded 4.47 QALYs and 4.91 ALYs. SLNB using blue dye and Tc99 was the most cost\u2010effective strategy when ALYs were considered with an incremental cost\u2010effectiveness ratio (ICER) of $144,531. When QALYs were considered, the SLNB technique using Tc99 and blue dye dominated all other strategies. SLNB using ICG cost $20,624 and yielded 4.90 ALYs and 4.54 QALYs. It was clinically superior to and less expensive than all other strategies when QALYs were the outcome of interest and had an ICER of $221,171 per ALY in comparison with RH plus PLND.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>SLNB using Tc99 and blue dye with ultrastaging is considered the most cost\u2010effective strategy with respect to 5\u2010year progression\u2010free survival and morbidity\u2010free survival. Although it was included only as an exploratory strategy in this study, SLNB with ICG has the potential to be the most cost\u2010effective strategy. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:1751\u20131759<\/jats:bold>. \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30509","type":"journal-article","created":{"date-parts":[[2017,1,24]],"date-time":"2017-01-24T11:59:11Z","timestamp":1485259151000},"page":"1751-1759","source":"Crossref","is-referenced-by-count":43,"title":["Cost\u2010effectiveness of sentinel node biopsy and pathological ultrastaging in patients with early\u2010stage cervical cancer"],"prefix":"10.1002","volume":"123","author":[{"given":"Harinder","family":"Brar","sequence":"first","affiliation":[{"name":"Division of Gynecological Oncology Department of Obstetrics and Gynecology, University of Toronto Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management, and Evaluation, 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