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  Contents > Previous page > Article detail print Order
o Issue N# 4 - 2010 o

ONCOLOGY

Comparison between external radiotherapy and laser micro­surgery for the treatment of TisT1N0 glottic carcinoma: clinical modelling and cost-minimization study from the French national health insurance payer’s point of view


Authors : Merrot O, Bige V, Poupart M, Montbarbon X, Ardiet J-M, Pignat J-C. (Lyon)

Ref. : Rev Laryngol Otol Rhinol. 2010;131,4:257-262.

Article published in french
Downloadable PDF document french



Summary : Objectives: The excellent effectiveness of both treatment modalities (radiotherapy, endoscopic laser surgery) for early glottic carcinoma (Tis, T1aN0) is similar (carcinologic, func­tio­nal and QoL results). This is part of an evidence-based medi­cine policy, which is to choose the cheapest of various treat­ment modalities known as equally effective and equally morbid. Is analytical economic approach useful and efficient to guide decision making? The aim of this study is to perform a cost-minimization analysis using an objective clinical modeling. Material and methods: For each modality, proba­bi­li­ties of various events were recorded from review of literature. Only local recurrences which constitute the major end-point affec­ting survival were considered. French national Health insu­rance’s point of view (as the payer’s point of view), with a 100% case-mix based payment system was used. Results of cost-minimization between laser endoscopic surgery and external radiation therapy are: Global Cost of laser endoscopic surgery is about 2613.01 €. Without (90% of cases) and with recurrence it is about 1700.36 € and 10826.87 € respectively. Global Cost of external radiation therapy is about 4490.88 €. Without (90% of cases) and with recurrence it is about 3578.23 € and 12704.74 € respectively. Conclu­sion: Cordectomy by CO2 laser seems to be an efficient cost-effective alternative to radio­therapy for early glottic carcinoma management from the French national Health insurance perspective.

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