welcome to oneFAPvoice
- a positively charged Familial Adenomatous Polyposis community.- join today!
- login
Cost-Effectiveness of Prophylactic Surgery for Duodenal Cancer in Familial Adenomatous Polyposis
source: Cancer epidemiology, biomarkers & prevention
year: 2009
authors: Wesley H. Greenblatt, Chin Hur, Amy B. Knudsen, John A. Evans, G. Scott Gazelle, Daniel C. Chung
summary/abstract:BACKGROUND : Duodenal cancer is the leading cause of cancer death in familial adenomatous polyposis after colorectal cancer. The lifetime risk for developing duodenal cancer is 4% to 10%. Current treatment guidelines recommend endoscopic surveillance with a prophylactic pancreaticoduodenectomy in advanced duodenal polyposis, defined using the Spigelman staging system. Because no clinical trials have assessed this recommendation, a modeling approach was used to evaluate the cost-effectiveness of various treatment strategies.
METHODS : A Markov model was constructed to estimate the life expectancy and cost of three different strategies: pancreaticoduodenectomy at Spigelman stage III, pancreaticoduodenectomy at Spigelman stage IV, and pancreaticoduodenectomy at cancer diagnosis. A cohort of 30-year-old familial adenomatous polyposis patients with total colectomies was simulated until age 80. The analysis was from a societal perspective. Extensive sensitivity analysis was performed to assess the impact of model uncertainty on results.
RESULTS : At all stages of polyposis and all ages
CONCLUSIONS : Prophylactic pancreaticoduodenectomy at stage IV duodenal polyposis in familial adenomatous polyposis is a cost-effective approach that results in greater life expectancy than surgery at either stage III or cancer diagnosis.
organization: Massachusetts General HospitalDOI: 10.1158/1055-9965.EPI-09-0153
read more full text source
expertly curated content related to this topic
-
Morbidity of Loop Ileostomy Closure after Restorative Proctocolectomy for Ulcerative Colitis and Familial Adenomatou...BACKGROUND: Temporary loop ileostomy is...
-
Restorative Proctocolectomy and Ileal Pouch-Anal Anastomosis in ChildrenPURPOSE : This study was designed to eva...
-
Risk of Cancer and Secondary Proctectomy After Colectomy and Ileorectal Anastomosis in Familial Adenomatous Polyposi...PURPOSE : The aim of our retrospective s...
-
Bowel Cancer – How Genetic Information can Help Reduce the RiskPaul’s story about the dominantly inhe...
-
Female Fertility after Colorectal Surgery for Familial Adenomatous Polyposis (FAP)Poster Presentation Background & ...
-
Rectal and Pouch Recurrences After Surgical Treatment for Familial Adenomatous PolyposisBACKGROUND : Familial adenomatous polypo...
-
Childbirth after Surgery for Familial Adenomatous Polyposis in JapanPURPOSE: Familial adenomatous polyposis...