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  • Cost effectiveness of endosonography versus surgical staging in potentially resectable lung cancer: a health economics analysis of the ASTER trial from a European perspective

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Chest clinic
Audit, research and guideline update
Cost effectiveness of endosonography versus surgical staging in potentially resectable lung cancer: a health economics analysis of the ASTER trial from a European perspective
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  1. Robert C Rintoul1,
  2. Matthew J Glover2,
  3. Christopher Jackson3,
  4. Victoria Hughes1,
  5. Kurt G Tournoy4,5,
  6. Christophe Dooms6,
  7. Jouke T Annema7,8,
  8. Linda D Sharples1,3,9
  1. 1Department of Thoracic Oncology, Papworth Hospital, Cambridge, UK
  2. 2Health Economics Research Group, Brunel University, Middlesex, UK
  3. 3MRC Biostatistics Unit, Institute of Public Health, Cambridge, UK
  4. 4Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
  5. 5Department of Respiratory Medicine, Onze-Lieve-Vrouwziekenhuis, Aalst, Belgium
  6. 6Department of Respiratory Medicine, University of Leuven, Leuven, Belgium
  7. 7Department of Pulmonology, Leiden University Medical Centre, Leiden, The Netherlands
  8. 8Department of Pulmonology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
  9. 9Clinical Trials Research Unit, University of Leeds, Leeds, UK
  1. Correspondence to Prof Linda Sharples, MRC Biostatistics Unit Cambridge, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 0SR, UK; linda.sharples{at}mrc-bsu.cam.ac.uk

Abstract

In the ASTER study, mediastinal staging was more accurate for patients randomised to combined endobronchial and endoscopic ultrasound, followed by surgical staging if endoscopy was negative, versus surgical staging alone. Here, we report survival, quality of life and cost effectiveness up to 6 months, for the UK, The Netherlands and Belgium, separately. Survival in the two arms of the study was similar. In all three countries, the endosonography strategy had slightly higher quality-adjusted life years over 6 months, and was cheaper. Therefore, based on clinical accuracy and cost effectiveness, we conclude that mediastinal staging should commence with endosonography.

  • Thoracic Surgery
  • Health Economist
  • Non-Small Cell Lung Cancer
  • Lung Cancer
  • Bronchoscopy

https://doi.org/10.1136/thoraxjnl-2013-204374

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