Article Text

Download PDFPDF
193 The implementation of sentinel lymph node biopsy for endometrial carcinoma at the Norwegian radium hospital: a cost-effectiveness analysis
  1. Pernille Bjerre Trent1,
  2. Ane Gerda Eriksson1,
  3. Anne Cathrine Staff2,
  4. Knut Erling Juul-Hansen3,
  5. Emily Annika Burger4 and
  6. Knut Reidar Wangen4
  1. 1Dept. of Gynecologic Oncology, Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
  2. 2Faculty of Medicine, University of Oslo, Oslo, Norway
  3. 3Dept. of Anesthesia and Intensive Care Medicine, Oslo University Hospital, Oslo, Norway
  4. 4Dept. of Health Management and Health Economics, Faculty of Medicine, University of Oslo, Oslo, Norway


Introduction/Background Sentinel lymph node biopsy (SLN) is increasingly used for surgical staging of endometrial carcinoma, due to its good detection rate of metastatic lymph nodes, low complication rate and reduced lower extremity lymphedema (LEL) compared with lymph node dissection (LND). However, the cost-effectiveness of SLN implementation for intermediate- and high-risk patients compared with LND has not previously been assessed and is the purpose of this study.

Methodology We performed a model-based cost-effectiveness analysis to quantify the health and economic outcomes associated with SLN implementation using the robotic platform compared with LND over a 9-year time horizon. Model parameters were informed using data from 829 women treated at Oslo University Hospital (OUH) 2013–2021.We selected a health care provider perspective and measured costs in Norwegian kroner (NOK) adjusted to 2022 values ($ 1 = 9.62 NOK). Costs were measured directly from OUH, while health outcomes were self-reported lymphedema and quality of life among survivors. We conducted one-way deterministic and probabilistic sensitivity analyses to evaluate model uncertainty.

Results We projected that on average, SLN yielded lower costs and improved health outcomes compared to LND. In a one-way sensitivity analysis, SLN remained cost-effective when factors considered as cost-drivers (the cost of robotic platform, surgical equipment, number of yearly robotic procedures, percentage of robotic procedures versus percentage of laparotomies, length of stay and LEL development) were varied over wide ranges. In a probabilistic sensitivity analysis with 1000 simulations, SLN provided greater health benefits for less costs (i.e., cost-savings) in 89% of our simulations (figure 1).

Conclusion Implementation of a SLN algorithm is likely considered cost-effective compared to LND, with lower costs and improved health outcomes, in the treatment of women with intermediate- and high-risk endometrial carcinoma. Increasing the number of yearly robotic surgeries and reducing length of stay could further improve cost-effectiveness.

Disclosures See attachments

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.