Abstract:
OBJECTIVE:To evaluate, from a societal perspective, the cost-effectiveness of adding bevacizumab to first-line therapy based on outcomes from the GOG-218 and ICON-7 trials. METHODS:A three-state Markov model was used. The time horizon was until the death of 99% of the initial cohort of 1000 individuals. Costs and quality-adjusted life-years (QALYs) were discounted at an annual rate of 3%. All costs were adjusted to 2013 USD. The incremental cost-effectiveness ratio (ICER) was reported as incremental cost per QALY gained. The robustness of the result was checked with one-way sensitivity analyses and for relevant clinical situations (i.e. varying the drug of choice to treat cancer recurrence). Subgroup analysis was conducted to identify subgroup of population for whom the strategy could be cost-effective. The potential impact of biosimilar bevacizumab was considered, using a 30% price reduction. RESULTS:For the GOG-218 study protocol, widely followed in US, the addition of bevacizumab results in an ICER of $2,420,691/QALY. For the ICON-7 study protocol, the ICER is $225,515/QALY. The results of the model were sensitive to the quality of life (QoL) and the median progression free survival (PFS). Biosimilar bevacizumab didn't reduce cost sufficiently to change conclusions. First-line augmentation is cost-effective, with biosimilar bevacizumab, for stage IV patients ($126,169/QALY), ECOG PS1 patients ($116,575/QALY) and for patients with suboptimal residual disease ($122,822/QALY) as per the ICON-7 protocol. CONCLUSION:Addition of bevacizumab, by in large, is cost-ineffective. It can become cost-effective with the ICON-7 protocol, in patients at high risk of progression using biosimilar bevacizumab.
journal_name
Gynecol Oncoljournal_title
Gynecologic oncologyauthors
Mehta DA,Hay JWdoi
10.1016/j.ygyno.2014.01.021subject
Has Abstractpub_date
2014-03-01 00:00:00pages
677-83issue
3eissn
0090-8258issn
1095-6859pii
S0090-8258(14)00037-7journal_volume
132pub_type
杂志文章abstract:BACKGROUND:Hydronephrosis can be a side effect of radical hysterectomy for cervical cancer. The incidence of clinically relevant hydronephrosis has not been studied in a large sample and the benefit of early detection of hydronephrosis is not clear. OBJECTIVE:To assess the incidence of hydronephrosis, following radica...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.09.010
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVE:To determine whether squamous cervical cancers exhibit mutations or deletions in MHC class I genes or transport-associated protein (TAP) genes. METHODS:Polymerase chain reaction based protocols were used to examine HLA class I and TAP genes in a panel of cervical tumours, using DNA from corresponding blood s...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.11.037
更新日期:2004-03-01 00:00:00
abstract::The COVID-19 pandemic has challenged our ability to provide timely surgical care for our patients. In response, the U.S. Surgeon General, the American College of Srugeons, and other surgical professional societies recommended postponing elective surgical procedures and proceeding cautiously with cancer procedures that...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2020.06.001
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:To evaluate testing for high-risk human papillomavirus (HR HPV) E6/E7 mRNA transcripts 6 months after conisation for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) to determine the risk of residual CIN2+. METHODS:We prospectively followed 344 women treated for CIN2+ by conisation. HR HPV mRNA te...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.07.032
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:ATP-binding Cassette (ABC) transporters are thought to cause multiple drug resistance (MDR) in various carcinomas. Gene expression data from individual transporters in ovarian cancer tissue is contradictory and also scarce for some of them. RNA levels of a panel of ABC transporters were collected and analyzed...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.10.077
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVES:Intraperitoneal (IP) chemotherapy following neoadjuvant chemotherapy (NACT) and interval tumor reductive surgery (TRS) for advanced ovarian cancer is feasible, however, the impact on disease outcomes remains unclear. We compare outcomes of patients treated with IP chemotherapy versus intravenous (IV) chemoth...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2019.12.016
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:Despite the fact that endometrial cancer commonly occurs in elderly women, little is known about the outcome of the oldest old, those > 80 years of age. We examined the patterns of care and outcome of the oldest old women with endometrial cancer. METHODS:An analysis of women > 65 years of age with endometrio...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.02.040
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:Although the incidence of cervical adenocarcinoma is increasing, few genetic and epigenetic changes in its progression have been described. We hypothesized that RASSF1A methylation and KRAS and BRAF mutations may play an important role in cervical adenocarcinoma. METHODS:Archival primary carcinoma tissues (n...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.01.045
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Timely hospice referral is an essential component of quality end-of-life care, although a growing body of research suggests that for patients with various types of cancer, hospice referrals often occur very late in the course of care, and are marked by sociodemographic disparities. However, little is known a...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2011.11.041
更新日期:2012-04-01 00:00:00
abstract::Monoclonal antibody rp-28 directed against the ras gene product p21 has been studied to evaluate ras p21 expression in malignant and benign ovarian tissues. Some ovarian carcinomas of serous and mucinous cystadenocarcinomas, undifferentiated adenocarcinomas, and clear cell carcinomas demonstrated intense staining of r...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/0090-8258(92)90194-n
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVES:Uterine adenosarcomas (AS) are rare tumors composed of malignant stromal and benign epithelial components. We sought to evaluate the role of primary surgery, adjuvant treatments, and salvage therapies for patients with uterine adenosarcomas. METHODS:We identified all patients diagnosed with AS from 1990 to ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2012.12.036
更新日期:2013-04-01 00:00:00
abstract:OBJECTIVE:Incorporating topotecan into standard platinum/taxane chemotherapy for advanced ovarian cancer has been complicated by myelosuppression. This study evaluated sequential doublets of topotecan and carboplatin, followed by paclitaxel and carboplatin, in newly diagnosed advanced ovarian cancer patients. METHODS:...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ygyno.2004.05.021
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVE:To evaluate clinicopathological factors and survival outcome of patients with advanced epithelial ovarian carcinoma undergoing multiple bowel resections to achieve optimal (< or = 1 cm) cytoreduction. METHODS:A case-control study was performed identifying patients undergoing optimal primary cytoreductive sur...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.08.003
更新日期:2007-12-01 00:00:00
abstract::Most rhabdomyosarcomas (RMSs) of the female genital tract occur in infants and young children as sarcoma botryoides. Vaginal RMS occurring in a postmenopausal woman is extremely rare. To our knowledge, only three vaginal RMSs have been reported in patients who were over 50 years of age. Herein, the first case in Taiwa...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1006/gyno.1995.1251
更新日期:1995-09-01 00:00:00
abstract:OBJECTIVES:The goal of this work was to test the hypotheses that S-phase fraction (SPF) by DNA labeling index (SPF-LI) would predict the course of the disease for ovarian/peritoneal carcinomas and that SPF-LI would correlate better with pathologic classification and outcome than SPF by DNA flow cytometry (SPF-F). METH...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.2001.6184
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Vulvar synovial cell sarcomas are rare, with only four previously published cases in the literature. Traditionally, the primary management for these tumors has been surgery alone. CASE:We report a case of a large vulvar synovial cell sarcoma in a 50-year-old woman treated with comprehensive combined multimo...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2006.09.018
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:To determine if the timing of normalization of CA-125 levels during primary chemotherapy for epithelial ovarian cancer (EOC) could predict survival. METHODS:Patients who reached a complete clinical response for EOC with primary taxane/platinum-based chemotherapy were eligible. Patient demographics, chemother...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2009.04.019
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVE:Neuropilin-1 (NRP-1) is a receptor for both semaphorin and vascular endothelial growth factor and is up-regulated in a variety of human cancers. While there are some reports of NRP-1 expression in ovarian neoplasm, those results differ in pattern of its expression and its role in ovarian cancer is still uncle...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.02.005
更新日期:2007-06-01 00:00:00
abstract:BACKGROUND:Crohn's disease is a chronic inflammatory disorder characterized by focal, transmural inflammation of the intestine. Gynecologic involvement, including rectovaginal fistula formation, is frequent. Case #1. A 53-year-old female with a 30-year history of Crohn's disease and numerous perirectal fistulas develop...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2003.11.056
更新日期:2004-04-01 00:00:00
abstract::Breast cancer is the leading cause of cancer death in women. Ovarian cancer, although less frequent, is detected very late, and survival is correlated to early detection. Therefore, better methods for early detection would help to increase the number of survivors. The incidence of young women diagnosed with breast can...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2009.10.079
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:To determine the feasibility and safety of simple extra-fascial trachelectomy plus pelvic lymphadenectomy in young patients affected by early stage cervical cancer. METHODS:We have prospectively identified all patients with early-stage cervical cancer (stages IA2-IB1) referred to our department. Inclusion cr...
journal_title:Gynecologic oncology
pub_type: 临床试验,杂志文章
doi:10.1016/j.ygyno.2012.04.004
更新日期:2012-07-01 00:00:00
abstract:BACKGROUND:One of the most active chemotherapy combinations in advanced or recurrent cervical cancer is cisplatin-paclitaxel. However, this palliative regimen is associated with significant toxicity. Carboplatin-paclitaxel is thus an attractive option. METHODS:Patients with advanced or recurrent carcinoma of the cervi...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2005.03.037
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To determine if lymphadenectomy, chemotherapy and radiotherapy are associated with survival benefit among women with stage I uterine carcinosarcoma. METHODS:Women with stage I uterine carcinosarcoma (n=5614) were identified from the 1998-2013 National Cancer Data Base. Kaplan-Meier survival estimates and Cox...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2017.01.010
更新日期:2017-04-01 00:00:00
abstract::Non-healing wounds represent a significant cause of morbidity and mortality for a large portion of the adult population. Wounds that fail to heal are entrapped in a self-sustaining cycle of chronic inflammation leading to the destruction of the extracellular matrix. Among cancer patients, malnutrition, radiation, phys...
journal_title:Gynecologic oncology
pub_type: 杂志文章,评审
doi:10.1016/j.ygyno.2008.07.052
更新日期:2008-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the effect of orally administered medroxyprogesterone acetate upon angiogenesis in the myometrium of patients with complex endometrial hyperplasia. METHODS:Microvessel counts in the myometrium of consecutive patients with complex endometrial hyperplasia, treated with oral medroxyprogesterone acet...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1006/gyno.1998.5106
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:Protease-activated receptor-2 (PAR-2) is a G-protein-coupled receptor that is cleaved and activated by trypsin and tryptase. There is evidence that PAR-2 contributes to tumor progression in stomach, colon, pancreas, prostate and breast cancer patients. However, the role of PAR-2 in cervical cancer is still un...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2007.08.083
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVE:This study investigated the relationship between 13 proteins involved in DNA damage and the outcomes of patients with recurrent ovarian cancer (ROC). PATIENTS AND METHODS:Immunohistochemistry staining was performed in 114 diagnostic samples from patients with serous ROC who participated in the OVA-301 study,...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2013.10.032
更新日期:2014-01-01 00:00:00
abstract::Young women diagnosed with breast cancer typically face systemic treatments that may delay childbearing or permanently impair their fertility. These concerns add to the stress experienced by young cancer survivors. Timely counseling and providing fertility preservation through cryopreservation of eggs or embryos have ...
journal_title:Gynecologic oncology
pub_type: 社论
doi:10.1016/j.ygyno.2011.11.028
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:Abnormalities in the control of cell proliferation and apoptosis have been suggested to contribute to the development and progression of neoplasia. There are at least two pathways that activate apoptosis. The first is a mitochondria-dependent route governed by bcl-2 family proteins. The second is a parallel ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/s0090-8258(03)00411-6
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVE:Determining whether carcinomas concurrently involving endometrium and ovary are independent primary tumors (IPTs) or endometrial carcinomas with ovarian metastases (at least stage IIIA endometrial cancers, IIIA-EC) using clinicopathologic criteria is often challenging. Recent genomic studies showed that most ...
journal_title:Gynecologic oncology
pub_type: 杂志文章
doi:10.1016/j.ygyno.2018.10.033
更新日期:2019-01-01 00:00:00