{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T05:08:47Z","timestamp":1791954527701,"version":"4.3.4"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:00:00Z","timestamp":1779235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["80-85200-98-91044"],"award-info":[{"award-number":["80-85200-98-91044"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004528","name":"Maastricht University Medical Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004528","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,4]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Lymphaticovenous anastomosis (LVA) is an increasingly applied microsurgical option for lymphoedema. The aim of this study was to evaluate the cost-effectiveness of LVA combined with complex decongestive therapy (CDT) versus CDT alone for breast cancer-related lymphoedema (BCRL).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A cost-effectiveness analysis was performed as a pre-specified secondary outcome of an RCT comparing LVA combined with CDT versus CDT alone. The primary outcome of the trial was health-related quality of life (HRQoL). A societal perspective with a 2-year time horizon was adopted. Quality-adjusted life-years (QALYs) were derived from the EuroQol five-dimension, five-level (EQ-5D-5L) questionnaire. Uncertainty was assessed using bootstrapping and sensitivity analysis. Data were collected from four Dutch hospitals. The primary outcome was the incremental cost-effectiveness ratio (ICER).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n One hundred female patients were included (mean age 58.5\u2005years). Over 2\u2005years, mean total costs were \u20ac16 234 (LVA) versus \u20ac14 293 (CDT); adjusted mean difference \u20ac78 (95% c.i. \u2212\u20ac6044 to \u20ac6200). Mean(s.e.) QALYs were 1.636(0.003) (LVA) versus 1.579(0.002) (CDT); adjusted mean difference 0.045 (95% c.i. \u22120.021 to 0.112). The ICER from a societal perspective was \u20ac1716\/QALY, with probabilities of cost-effectiveness of 0.60 and 0.71 at the \u20ac20 000 and \u20ac50 000 willingness-to-pay thresholds respectively. From a healthcare perspective, the ICER was \u20ac59 679\/QALY, with probabilities of cost-effectiveness of 0.08 and 0.42 at the same thresholds respectively.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n LVA combined with CDT was more costly than CDT alone, but societal costs were limited during the 2-year follow-up interval. The LVA group acquired slightly more QALYs. From a societal perspective, LVA combined with CDT has the potential to be cost-effective, particularly when performed under local anaesthesia.<\/jats:p>\n <\/jats:sec>\n \n Registration number<\/jats:title>\n NCT02790021 (http:\/\/www.clinicaltrials.gov).<\/jats:p>\n <\/jats:sec>","DOI":"10.1093\/bjs\/znag062","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:43:42Z","timestamp":1779277422000},"source":"Crossref","is-referenced-by-count":1,"title":["Economic evaluation of lymphaticovenous anastomosis\n versus<\/i>\n conservative therapy for breast cancer-related lymphoedema: secondary outcome analysis of a randomized clinical trial"],"prefix":"10.1093","volume":"113","author":[{"given":"Alieske","family":"Kleeven","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Centre+ , Maastricht ,","place":["The Netherlands"]},{"name":"Department of Plastic Surgery, Radboud University Medical Centre , Nijmegen ,","place":["The Netherlands"]},{"name":"GROW, School for Oncology and Reproduction, Maastricht University , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmine M J","family":"Jonis","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Centre+ , Maastricht ,","place":["The Netherlands"]},{"name":"GROW, School for Oncology and Reproduction, Maastricht University , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Currie","sequence":"additional","affiliation":[{"name":"Faculty of Health, Medicine, and Life Sciences, Maastricht University , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"Wolfs","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Centre+ , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merel","family":"Kimman","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre+ , Maastricht ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanneke","family":"Tielemans","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Radboud University Medical Centre , Nijmegen ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ren\u00e9 R W J","family":"van der Hulst","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Centre+ , Maastricht ,","place":["The 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