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Health economic evaluation of watch and wait policy after clinical complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients

Hendriks, Pim (2016) Health economic evaluation of watch and wait policy after clinical complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients.

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Abstract:Background: Non-surgical Watch & Wait (W&W) policy has recently gained prominence in the treatment of patients with locally advanced rectal cancer with a clinical complete response after neoadjuvant chemoradiotherapy. By omitting surgery, peri and postoperative morbidity and mortality could be avoided. Objective: The aim of this study is to estimate long-term clinical value of Watch & Wait strategy in terms of quality of life, life expectancy and costs. Method: A Markov model was used with input parameters derived from demographics, literature and expert elicitation. A hypothetical population of 100,000 locally advanced rectal cancer patients was considered at the restaging phase after neoadjuvant therapy. The current golden standard of TME surgery was compared with W&W implementation, and a univariate sensitivity analysis was performed. Results: The model indicates that an implementation of Watch & Wait policy leads to an increase of Quality-Adjusted Life Years (QALYs) of 0.089 and cost savings of €511 ($583) per patient. Discussion: This study provides supportive evidence for the implementation W&W strategy. Furthermore, it shows an incentive for further research into increasing sensitivity and specificity rates for Watch & Wait inclusion.
Item Type:Essay (Master)
Clients:
University of Twente, Nederland
Faculty:TNW: Science and Technology
Subject:44 medicine, 83 economics
Programme:Health Sciences MSc (66851)
Link to this item:http://purl.utwente.nl/essays/70488
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