Real-world costs and dynamics of surveillance in patients who underwent surgery for low-risk branch duct intraductal papillary mucinous neoplasms. Issue 1 (January 2023)

• Record Type: Journal Article
• Authors: Tamburrino, Domenico; Cortesi, Paolo; Facchetti, Rita; de Pretis, Nicolò; Pérez-Cuadrado-Robles, Enrique; Uribarri-Gonzalez, Laura; Ateeb, Zeeshan; Belfiori, Giulio; Arcidiacono, Paolo Giorgio; Mantovani, Lorenzo Giovanni; Del Chiaro, Marco; Laukkarinen, Johanna; Falconi, Massimo; Crippa, Stefano; Capurso, Gabriele
• Is Part Of: European journal of surgical oncology. Volume 49:Issue 1(2023)
• Page Start: 137
• Page End: 141
• Publication Date: 2023-01
• Subjects: Intraductal papillary mucinous neoplasm -- Branch-duct IPNM -- Pancreatic surgery -- EUS -- Cost-effectiveness -- Pancreas -- Pancreatic cystic neoplasm; Oncology -- Periodicals; Cancer -- Surgery -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- surgery -- Periodicals; Cancer -- Chirurgie -- Périodiques; Cancérologie -- Périodiques; Oncologie; Chirurgie (geneeskunde); Electronic journals; Electronic journals -- Sciences; Electronic journals -- Medicine; Electronic journals; 616.994059005
• DOI: 10.1016/j.ejso.2022.08.033
• Languages: English
• ISSNs: 0748-7983

Abstract

Abstract: Surveillance costs and appropriateness of surgery of "low-risk" BD-IPMNs are relevant issues. In this study we evaluated the rate of correct indication for pancreatectomy defined as high grade dysplasia (HGD) at histology in 961 patients who underwent surveillance for a median of 5.1 years. Undertreatment and overtreatment were defined as invasive cancer and low grade dysplasia (LGD) at histology, respectively. Of the 66 patients (6.9%) who were operated, only 16 (23.8%) had a HGD while 40 (59.7%) had a LGD and 10 (14.9%) an invasive cancer, without differences regarding timing of surgery. The mean surveillance cost was € 194.9 ± 107.6 per patient-year, with a median cost of € 277.1 ± 148.2 in the correct surgery group compared with € 222.7 ± 111.6 and € 197 ± 102.7 in the overtreatment and undertreatment groups. The surveillance mean cost from diagnosis to surgery was € 854.8. Rate of appropriate surgery in BD-IPMNs under surveillance is low.