{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:47:12Z","timestamp":1787014032542,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T00:00:00Z","timestamp":1485820800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100010377","name":"National Institute for Health and Care Excellence","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010377","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2017,4]]},"abstract":"\n Objectives<\/jats:title>\n To identify the most cost\u2010effective treatment strategy in patients with early stage (T1 and T2) cancers of the laryngeal glottis.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n \n A Markov decision model populated using data from updated systematic reviews and meta\u2010analyses, with attributable costs from\n NHS<\/jats:styled-content>\n sources. Data on local control and mortality were obtained from updates of existing systematic reviews conducted for the\n NICE<\/jats:styled-content>\n guideline on cancer of the upper aerodigestive tract. Procedure costs were sourced from\n NHS<\/jats:styled-content>\n reference costs 2013\/14 by applying tariffs associated with the appropriate health resource group code\n <\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n \n The\n UK<\/jats:styled-content>\n National Health Service.\n <\/jats:p>\n <\/jats:sec>\n \n Population<\/jats:title>\n Patients with early stage (T1 and T2) cancers of the laryngeal glottis.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n \n Transoral laser microsurgery (\n TLM<\/jats:styled-content>\n ) and radiation therapy (\n RT<\/jats:styled-content>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n \n Total costs, incremental costs and quality adjusted life years (\n QALY<\/jats:styled-content>\n s) over a 10\u2010year time horizon.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Radiation therapy as the initial treatment strategy was found to be more expensive (\u00a32654\n versus<\/jats:italic>\n \u00a3623) and less effective (\n QALY<\/jats:styled-content>\n reduction of 0.141 and 0.04 in T1a and T1b\u2013T2 laryngeal cancers, respectively) than\n TLM<\/jats:styled-content>\n . The dominance of\n TLM<\/jats:styled-content>\n for T1a cancers was unchanged in most scenarios modelled in sensitivity analysis. For T1b\u2013T2 laryngeal cancers, the result changed in numerous scenarios. In probabilistic sensitivity analysis,\n TLM<\/jats:styled-content>\n was found to have a 71% and 58% probability of being cost\u2010effective in T1a and T1b\u2013T2 laryngeal cancers, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Transoral laser microsurgery is a cost\u2010effective strategy to adopt in the management of T1a laryngeal cancers. Uncertainty remains over the optimal strategy to adopt in T1b\u2013T2 laryngeal cancers.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/coa.12807","type":"journal-article","created":{"date-parts":[[2016,12,14]],"date-time":"2016-12-14T05:52:35Z","timestamp":1481694755000},"page":"404-415","source":"Crossref","is-referenced-by-count":30,"title":["Transoral laser microsurgery\n versus<\/i>\n radiation therapy in the management of T1 and T2 laryngeal glottic carcinoma: which modality is cost\u2010effective within the\n UK<\/scp>\n ?"],"prefix":"10.1111","volume":"42","author":[{"given":"M.","family":"Prettyjohns","sequence":"first","affiliation":[{"name":"National Collaborating Centre for Cancer Cardiff UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Winter","sequence":"additional","affiliation":[{"name":"Oxford University Hospitals Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Kerawala","sequence":"additional","affiliation":[{"name":"Royal Marsden Hospitals London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7933-4585","authenticated-orcid":false,"given":"V.","family":"Paleri","sequence":"additional","affiliation":[{"name":"Newcastle upon Tyne Hospitals Newcastle upon Tyne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the NICE cancer of the upper aerodigestive tract guideline committee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,31]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"National Institute for Health and Care Excellence(2016).Cancer of the upper aerodigestive tract: assessment and management in people aged 16 and over 2016. 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