• Koji Matsuo, Ling Chen, Shinya Matsuzaki, Rachel S Mandelbaum, Katharine M Ciesielski, Jack P Silva, Maximilian Klar, Lynda D Roman, Melissa K Accordino, Alexander Melamed, Elena Elkin, Dawn L Hershman, and Jason D Wright.
• University of Southern California, Los Angeles, CA.
• Ann. Surg. 2023 May 1; 277 (5): e1116e1123e1116-e1123.

ObjectiveTo perform a cost-effectiveness analysis to examine the utility and effectiveness of OS performed at the time of elective cholecystectomy [laparoscopic cholecystectomy (LAP-CHOL)].Summary Background DataOS has been adopted as a strategy to reduce the risk of ovarian cancer in women undergoing hysterectomy and tubal sterilization, although the procedure is rarely performed as a risk reducing strategy during other abdominopelvic procedures.MethodsA decision model was created to examine women 40, 50, and 60 years of age undergoing LAP-CHOL with or without OS. The lifetime risk of ovarian cancer was assumed to be 1.17%, 1.09%, and 0.92% for women age 40, 50, and 60 years, respectively. OS was estimated to provide a 65% reduction in the risk of ovarian cancer and to require 30 additional minutes of operative time. We estimated the cost, quality-adjusted life-years, ovarian cancer cases and deaths prevented with OS.ResultsThe additional cost of OS at LAP-CHOL ranged from $1898 to 1978. In a cohort of 5000 women, OS reduced the number of ovarian cancer cases by 39, 36, and 30 cases and deaths by 12, 14, and 16 in the age 40-, 50-, and 60-year-old cohorts, respectively. OS during LAP-CHOL was cost-effective, with incremental cost-effectiveness ratio of $11,162 to 26,463 in the 3 age models. In a probabilistic sensitivity analysis, incremental cost-effectiveness ratio for OS were less than $100,000 per quality-adjusted life-years in 90.5% or more of 1000 simulations.ConclusionsOS at the time of LAP-CHOL may be a cost-effective strategy to prevent ovarian cancer among average risk women.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

12 keywords...

hide…