Cost-effectiveness of sentinel lymph node biopsy in thin melanomas

Doreen M. Agnese, Shahab F Abdessalam, William E. Burak, Cynthia M. Magro, Rodney V. Pozderac, Michael J. Walker, Jose M. Velasco, Gerard V. Aranha

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Abstract

Background. Consideration of sentinel lymph node biopsy (SLNB) is recommended for thin melanomas with poor prognostic features; however, few metastases are identified. The purpose of this study was to assess the cost effectiveness of SLNB in this population. Methods. The prospective melanoma database was reviewed to identify patients with melanomas <1.2 mm thick who had undergone SLNB. Physician and hospital charges were collected from the appropriate billing department. Results. A total of 138 patients were identified over an 8-year period (1994-2002). Two patients with positive SLNs were identified (1.4%), one with a melanoma <1 mm thick. Patient charges for SLNB ranged from $10,096 to $15,223, compared with $1000 to $1740 for wide excision as an outpatient. Using these charges, the cost to identify a single positive SLN would be between $696,600 and $1,051,100. The cost for wide excision would be between $69,000 and $120,100. Assuming that all patients with a positive SLN would die of melanoma, the cost per life saved would be $627,000 to $931,000. Conclusions. The cost of performing SLNB in this population is great and only a small number will have disease identified that will alter treatment. These data call into question the appropriateness of SLNB for thin melanomas.

Original languageEnglish (US)
Pages (from-to)542-547
Number of pages6
JournalSurgery
Volume134
Issue number4
DOIs
StatePublished - Jan 1 2003

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Sentinel Lymph Node Biopsy
Cost-Benefit Analysis
Melanoma
Costs and Cost Analysis
Hospital Charges
Population
Outpatients
Databases
Neoplasm Metastasis
Physicians

ASJC Scopus subject areas

  • Surgery

Cite this

Agnese, D. M., Abdessalam, S. F., Burak, W. E., Magro, C. M., Pozderac, R. V., Walker, M. J., ... Aranha, G. V. (2003). Cost-effectiveness of sentinel lymph node biopsy in thin melanomas. Surgery, 134(4), 542-547. https://doi.org/10.1016/S0039-6060(03)00275-7

Cost-effectiveness of sentinel lymph node biopsy in thin melanomas. / Agnese, Doreen M.; Abdessalam, Shahab F; Burak, William E.; Magro, Cynthia M.; Pozderac, Rodney V.; Walker, Michael J.; Velasco, Jose M.; Aranha, Gerard V.

In: Surgery, Vol. 134, No. 4, 01.01.2003, p. 542-547.

Research output: Contribution to journalArticle

Agnese, DM, Abdessalam, SF, Burak, WE, Magro, CM, Pozderac, RV, Walker, MJ, Velasco, JM & Aranha, GV 2003, 'Cost-effectiveness of sentinel lymph node biopsy in thin melanomas', Surgery, vol. 134, no. 4, pp. 542-547. https://doi.org/10.1016/S0039-6060(03)00275-7
Agnese DM, Abdessalam SF, Burak WE, Magro CM, Pozderac RV, Walker MJ et al. Cost-effectiveness of sentinel lymph node biopsy in thin melanomas. Surgery. 2003 Jan 1;134(4):542-547. https://doi.org/10.1016/S0039-6060(03)00275-7
Agnese, Doreen M. ; Abdessalam, Shahab F ; Burak, William E. ; Magro, Cynthia M. ; Pozderac, Rodney V. ; Walker, Michael J. ; Velasco, Jose M. ; Aranha, Gerard V. / Cost-effectiveness of sentinel lymph node biopsy in thin melanomas. In: Surgery. 2003 ; Vol. 134, No. 4. pp. 542-547.
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N2 - Background. Consideration of sentinel lymph node biopsy (SLNB) is recommended for thin melanomas with poor prognostic features; however, few metastases are identified. The purpose of this study was to assess the cost effectiveness of SLNB in this population. Methods. The prospective melanoma database was reviewed to identify patients with melanomas <1.2 mm thick who had undergone SLNB. Physician and hospital charges were collected from the appropriate billing department. Results. A total of 138 patients were identified over an 8-year period (1994-2002). Two patients with positive SLNs were identified (1.4%), one with a melanoma <1 mm thick. Patient charges for SLNB ranged from $10,096 to $15,223, compared with $1000 to $1740 for wide excision as an outpatient. Using these charges, the cost to identify a single positive SLN would be between $696,600 and $1,051,100. The cost for wide excision would be between $69,000 and $120,100. Assuming that all patients with a positive SLN would die of melanoma, the cost per life saved would be $627,000 to $931,000. Conclusions. The cost of performing SLNB in this population is great and only a small number will have disease identified that will alter treatment. These data call into question the appropriateness of SLNB for thin melanomas.

AB - Background. Consideration of sentinel lymph node biopsy (SLNB) is recommended for thin melanomas with poor prognostic features; however, few metastases are identified. The purpose of this study was to assess the cost effectiveness of SLNB in this population. Methods. The prospective melanoma database was reviewed to identify patients with melanomas <1.2 mm thick who had undergone SLNB. Physician and hospital charges were collected from the appropriate billing department. Results. A total of 138 patients were identified over an 8-year period (1994-2002). Two patients with positive SLNs were identified (1.4%), one with a melanoma <1 mm thick. Patient charges for SLNB ranged from $10,096 to $15,223, compared with $1000 to $1740 for wide excision as an outpatient. Using these charges, the cost to identify a single positive SLN would be between $696,600 and $1,051,100. The cost for wide excision would be between $69,000 and $120,100. Assuming that all patients with a positive SLN would die of melanoma, the cost per life saved would be $627,000 to $931,000. Conclusions. The cost of performing SLNB in this population is great and only a small number will have disease identified that will alter treatment. These data call into question the appropriateness of SLNB for thin melanomas.

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