caa a22 4500 475780159 CHVBK 20180406123642.0 cr unu---uuuuu 170329e20000301xx s 000 0 eng 10.1007/PL00021298 doi (NATIONALLICENCE)springer-10.1007/PL00021298 Cost-effectiveness of different diagnostic strategies in patients with nonresectable upper gastrointestinal tract malignancies [Elektronische Daten] [M. B. Mortensen, A. P. Ainsworth, L. K. Langkilde, J. D. Scheel-Hincke, T. Pless, C. Hovendal] Background and methods: Using a simple model, this retrospective study evaluated the cost-effectiveness of different diagnostic strategies used for pretherapeutic detection of patients with disseminated or locally nonresectable upper gastrointestinal tract malignancies (UGIM). Of 162 consecutive UGIM patients referred for treatment, 73 (45%) had disseminated or locally nonresectable disease, and these patients were eligible for evaluation. Results: The noninvasive diagnostic strategies (computed tomography [CT] with ultrasonography [US] and endoscopic ultrasonography [EUS]) had a low procedure cost, but a diagnostic strategy based on CT with US or CT with US and laparoscopy was not cost-effective. The inclusion of endoscopic or laparoscopic ultrasonography seemed necessary to the provision of a cost-effective strategy because both techniques had a high diagnostic accuracy combined with a low cost. A change in diagnostic strategy from CT with US to CT with US and EUS resulted in a net saving regarding the cost of each additional nonresectable patient detected, but this strategy still required up to 20% futile explorative laparotomies. Conclusions: The combination of endoscopic and laparoscopic ultrasonography was cost-effective and had no complications in this study. We use this strategy as our standard in the pretherapeutic evaluation of UGIM patients. Springer-Verlag New York Inc., 2000 Key words: Cancer — Cost-effectiveness — Endoscopic ultrasound — Imaging — Laparoscopic ultrasound nationallicence Mortensen M. B. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut Ainsworth A. P. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut Langkilde L. K. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut Scheel-Hincke J. D. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut Pless T. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut Hovendal C. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 278-281 0930-2794 14:3<278 2000 14 464 https://doi.org/10.1007/PL00021298 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/PL00021298 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Mortensen M. B. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut NATIONALLICENCE 700 1- Ainsworth A. P. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut NATIONALLICENCE 700 1- Langkilde L. K. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut NATIONALLICENCE 700 1- Scheel-Hincke J. D. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut NATIONALLICENCE 700 1- Pless T. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut NATIONALLICENCE 700 1- Hovendal C. Department of Surgical Gastroenterology, Odense University Hospital, DK-5000 Odense C, Denmark, Denmark aut NATIONALLICENCE 773 0- Surgical Endoscopy Springer-Verlag 14/3(2000-03-01), 278-281 0930-2794 14:3<278 2000 14 464 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer