دورية أكاديمية
Clinical implementation of routine diagnostic laparoscopy to guide initial treatment in patients with advanced-stage epithelial ovarian cancer in Dutch clinical practice: Evaluation of support and a budget impact analysis.
| العنوان: | Clinical implementation of routine diagnostic laparoscopy to guide initial treatment in patients with advanced-stage epithelial ovarian cancer in Dutch clinical practice: Evaluation of support and a budget impact analysis. |
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| المؤلفون: | Lof P; Department of Gynecologic Oncology, Center for Gynecologic Oncology Amsterdam, the Netherlands Cancer Institute, Amsterdam, the Netherlands. Electronic address: p.lof@nki.nl., Retèl VP; Department of Health Technology Assessment, the Netherlands Cancer Institute, Amsterdam, the Netherlands; Department of Health Technology and Services Research, University of Twente, Enschede, the Netherlands., Algera MD; Dutch Institute for Clinical Auditing (DICA), Scientific Bureau, Leiden, the Netherlands; Department of Obstetrics and Gynecology, Maastricht University Medical Center (MUMC), Maastricht, the Netherlands., van Gent MDJM; Center for Gynecologic Oncology Amsterdam, Amsterdam University Medical Center, Amsterdam, the Netherlands., Gaarenstroom KN; Department of Gynecology, Leiden University Medical Center, Leiden, the Netherlands., van Driel WJ; Department of Gynecologic Oncology, Center for Gynecologic Oncology Amsterdam, the Netherlands Cancer Institute, Amsterdam, the Netherlands. |
| المصدر: | Gynecologic oncology [Gynecol Oncol] 2022 Jun; Vol. 165 (3), pp. 459-465. Date of Electronic Publication: 2022 Apr 09. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Academic Press Country of Publication: United States NLM ID: 0365304 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-6859 (Electronic) Linking ISSN: 00908258 NLM ISO Abbreviation: Gynecol Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York, Academic Press. |
| مواضيع طبية MeSH: | Laparoscopy*/methods , Ovarian Neoplasms*/diagnosis , Ovarian Neoplasms*/surgery, Carcinoma, Ovarian Epithelial/drug therapy ; Carcinoma, Ovarian Epithelial/therapy ; Cytoreduction Surgical Procedures/adverse effects ; Female ; Humans ; Hyperthermic Intraperitoneal Chemotherapy |
| مستخلص: | Objective: In patients with advanced-stage epithelial ovarian cancer (EOC), a diagnostic laparoscopy (DLS) to determine treatment regime prevents futile laparotomies and seems cost-neutral. The uptake of DLS in current practice is unknown. We evaluated the clinical application of routine DLS in treatment planning in patients with advanced-stage EOC in the Netherlands. Methods: The implementation was evaluated over the period 2017-2019, using a health technology assessment including clinical, organizational, and economic factors. Barriers for implementation were identified and DLS use was assessed using semi-structured surveys with healthcare professionals. Data from the Dutch Gynecological Oncology Audit were used to determine (un)successful CRS rates. To assess the economic impact, we performed a budget impact analysis (BIA) of the combined interventions of DLS and primary CRS. Results: The DLS use to guide treatment planning increased from 16% to 20%. The majority of the centers did not support routine DLS implementation, mainly because of logistic barriers and its invasive nature. The primary CRS rate of all CRS decreased from 44% to 36%, in favor of interval CRS. The unsuccessful primary CRS rate decreased from 15% to 9% resulting in fewer patients needed a second interval CRS. Consequently, total health care costs decreased from €4.457.496 to €4.274.751. Conclusions: The implementation of routine DLS for guiding treatment planning in patients with advanced-stage EOC has limited support in the Netherlands. Over the years, total health care costs decreased. For current practice, it is advised that a DLS is useful in case it is uncertain whether a successful primary CRS is feasible based on conventional work-up. Competing Interests: Declaration of Competing Interest All authors declare no conflict of interest. (Copyright © 2022 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Advanced-stage epithelial ovarian cancer; Budgetimpact analyses; Diagnostic laparoscopy; Implementation process; Primary cytoreductive surgery |
| تواريخ الأحداث: | Date Created: 20220413 Date Completed: 20220525 Latest Revision: 20220716 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.ygyno.2022.03.028 |
| PMID: | 35414427 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1095-6859 |
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| DOI: | 10.1016/j.ygyno.2022.03.028 |