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Three-year postoperative surveillance cost-effective for patients with low-risk papillary thyroid cancer
Compared with annual surveillance, postoperative surveillance every 3 years, after 5 years of annual surveillance is projected to be cost-effective in patients with low-risk papillary thyroid cancer, according to researchers.
James X. Wu, MD, of the UCLA David Geffen School of Medicine, and colleagues used a Markov discrete time state transition model to compare annual postoperative surveillance and postoperative surveillance every 3 years after 5 years of annual surveillance in patients with low-risk papillary thyroid cancer (PTC). The reference case was defined as having negative neck ultrasound and stimulated thyroglobulin less than 2 ng/mL 1-year after total thyroidectomy for a 2-cm noninvasive PTC.
Researchers found that annual surveillance cost $5,239 with 22.49 quality adjusted life years. The 3-year surveillance cost $2,601 less with 0.01 less quality adjusted life years than annual surveillance. An incremental cost of $260,100 per quality adjusted life year was found with annual surveillance.
If the cost of ultrasound could be reduced to less than $23, annual surveillance would become more cost-effective than 3-year surveillance, according to researchers.
“In conclusion, tapering postoperative surveillance to 3-year intervals after 5 years of annual surveillance is more cost-effective than annual surveillance for patients with low-risk PTC with excellent response to initial therapy,” the researchers wrote. “Given the very favorable prognosis in this subset of patients, and the added costs of perpetual annual surveillance with essentially equivalent outcomes, clinicians could consider using a less frequent long-term follow-up interval.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.