Clinical efficacy and cost-effectiveness of endobronchial ultrasound-guided transbronchial needle aspiration for preoperative staging of non-small-cell lung cancer: Results of a French prospective multicenter trial (EVIEPEB)

被引：11

作者：

Chouaid, Christos ^{[1
]}

Salaun, Mathieu ^{[2
]}

Gounant, Valerie ^{[3
]}

Febvre, Michel ^{[4
]}

Vergnon, Jean-Michel ^{[5
]}

Jouniaux, Vincent ^{[6
]}

Fournier, Clement ^{[7
]}

Lachkar, Samy ^{[2
]}

Hermant, Christophe ^{[8
]}

Raspaud, Christophe ^{[9
]}

Quantin, Xavier ^{[10
]}

Quiot, Jean-Jacques ^{[11
]}

Molard, Anita ^{[12
]}

Dayen, Charles ^{[13
]}

Marquette, Charles-Hugo ^{[14
]}

Lena, Herve ^{[15
]}

Zalcman, Gerard ^{[3
]}

Thiberville, Luc ^{[2
]}

机构：

[1] CHI Creteil, Dept Pneumol, Creteil, France

[2] CHU Rouen, Dept Pneumol, Rouen, France

[3] CHU Bichat, AP HP, Dept Pneumol, Paris, France

[4] CHU Tenon, AP HP, Dept Pneumol, Paris, France

[5] CHU St Etienne, Dept Pneumol, St Etienne, France

[6] CHU Amiens, Dept Pneumol, Amiens, France

[7] CHU Lille, Dept Pneumol, Lille, France

[8] CHU Toulouse, Dept Pneumol, Toulouse, France

[9] Clin Pasteur Toulouse, Toulouse, France

[10] CHU Montpellier, Dept Pneumol, Montpellier, France

[11] CHU Brest, Dept Pneumol, Brest, France

[12] CHU Strasbourg, Dept Pneumol, Strasbourg, France

[13] CH St Quentin, Dept Pneumol, St Quentin en Yvelines, France

[14] CHU Nice, Dept Pneumol, Nice, France

[15] CHU Rennes, Dept Pneumol, Rennes, France

来源：

PLOS ONE | 2019年 / 14卷 / 01期

关键词：

ECONOMIC-ANALYSIS; MEDIASTINOSCOPY; DIAGNOSIS; TOOL;

D O I：

10.1371/journal.pone.0208992

中图分类号：

O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];

学科分类号：

07 ; 0710 ; 09 ;

摘要：

This two-step study evaluated the cost-effectiveness of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for presurgery staging of non-small cell lung cancer (NSCLC) in France (EVIEPEB; ClinicalTrial.gov identifier NCT00960271). Step 1 consisted of a high-benchmark EBUS-TBNA training program in participating hospital centers. Step 2 was a prospective, national, multicenter study on patients with confirmed or suspected NSCLC and an indication for mediastinal staging with at least one lymph node > 1 cm in diameter. Patients with negative or uninformative EBUS-TBNA and positron-emission tomography-positive or-negative nodes, respectively, underwent either mediastinoscopy or surgery. Direct costs related to final diagnosis of node status were prospectively recorded. Sixteen of 22 participating centers were certified by the EBUS-TBNA training program and enrolled 163 patients in Step 2. EBUS-TBNA was informative for 149 (91%) patients (75 malignant, 74 non-malignant) and uninformative for 14 (9%). Mediastinoscopy was avoided for 80% of the patients. With a 52% malignant-node rate, EBUS-TBNA positive and negative-predictive values, respectively, were 100% and 90%. EBUS-TBNA was costeffective, with expected savings of 1,450 per patient, and would have remained cost-effective even if all EBUS-TBNAs had been performed under general anesthesia or the cost of the procedure had been 30% higher (expected cost-saving of 994 and 1,427 per patient, respectively). After EBUS-TBNA training and certification of participating centers, the results of this prospective multicenter study confirmed EBUS-TBNA cost-effectiveness for NSCLC staging.

引用

页数：10

共 25 条

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