Costs and quality of life in a randomized trial comparing minimally invasive and open distal pancreatectomy (LEOPARD trial)

on behalf of the Dutch Pancreatic Cancer Group and LEOPARD trial collaborators

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Minimally invasive distal pancreatectomy decreases time to functional recovery compared with open distal pancreatectomy, but the cost-effectiveness and impact on disease-specific quality of life have yet to be established. Methods: The LEOPARD trial randomized patients to minimally invasive (robot-assisted or laparoscopic) or open distal pancreatectomy in 14 Dutch centres between April 2015 and March 2017. Use of hospital healthcare resources, complications and disease-specific quality of life were recorded up to 1 year after surgery. Unit costs of hospital healthcare resources were determined, and cost-effectiveness and cost–utility analyses were performed. Primary outcomes were the costs per day earlier functional recovery and per quality-adjusted life-year. Results: All 104 patients who had a distal pancreatectomy (48 minimally invasive and 56 open) in the trial were included in this study. Patients who underwent a robot-assisted procedure were excluded from the cost analysis. Total medical costs were comparable after laparoscopic and open distal pancreatectomy (mean difference €–427 (95 per cent bias-corrected and accelerated confidence interval €–4700 to 3613; P = 0·839). Laparoscopic distal pancreatectomy was shown to have a probability of at least 0·566 of being more cost-effective than the open approach at a willingness-to-pay threshold of €0 per day of earlier recovery, and a probability of 0·676 per additional quality-adjusted life-year at a willingness-to-pay threshold of €80 000. There were no significant differences in cosmetic satisfaction scores (median 9 (i.q.r. 5·75–10) versus 7 (4–8·75); P = 0·056) and disease-specific quality of life after minimally invasive (laparoscopic and robot-assisted procedures) versus open distal pancreatectomy. Conclusion: Laparoscopic distal pancreatectomy was at least as cost-effective as open distal pancreatectomy in terms of time to functional recovery and quality-adjusted life-years. Cosmesis and quality of life were similar in the two groups 1 year after surgery.
Original languageEnglish
JournalBritish Journal of Surgery
DOIs
Publication statusPublished - 2019

Cite this

@article{31a51100518f4f12998c78c066e877b7,
title = "Costs and quality of life in a randomized trial comparing minimally invasive and open distal pancreatectomy (LEOPARD trial)",
abstract = "Background: Minimally invasive distal pancreatectomy decreases time to functional recovery compared with open distal pancreatectomy, but the cost-effectiveness and impact on disease-specific quality of life have yet to be established. Methods: The LEOPARD trial randomized patients to minimally invasive (robot-assisted or laparoscopic) or open distal pancreatectomy in 14 Dutch centres between April 2015 and March 2017. Use of hospital healthcare resources, complications and disease-specific quality of life were recorded up to 1 year after surgery. Unit costs of hospital healthcare resources were determined, and cost-effectiveness and cost–utility analyses were performed. Primary outcomes were the costs per day earlier functional recovery and per quality-adjusted life-year. Results: All 104 patients who had a distal pancreatectomy (48 minimally invasive and 56 open) in the trial were included in this study. Patients who underwent a robot-assisted procedure were excluded from the cost analysis. Total medical costs were comparable after laparoscopic and open distal pancreatectomy (mean difference €–427 (95 per cent bias-corrected and accelerated confidence interval €–4700 to 3613; P = 0·839). Laparoscopic distal pancreatectomy was shown to have a probability of at least 0·566 of being more cost-effective than the open approach at a willingness-to-pay threshold of €0 per day of earlier recovery, and a probability of 0·676 per additional quality-adjusted life-year at a willingness-to-pay threshold of €80 000. There were no significant differences in cosmetic satisfaction scores (median 9 (i.q.r. 5·75–10) versus 7 (4–8·75); P = 0·056) and disease-specific quality of life after minimally invasive (laparoscopic and robot-assisted procedures) versus open distal pancreatectomy. Conclusion: Laparoscopic distal pancreatectomy was at least as cost-effective as open distal pancreatectomy in terms of time to functional recovery and quality-adjusted life-years. Cosmesis and quality of life were similar in the two groups 1 year after surgery.",
author = "{on behalf of the Dutch Pancreatic Cancer Group and LEOPARD trial collaborators} and {van Hilst}, J. and Strating, {E. A.} and {de Rooij}, T. and F. Daams and S. Festen and {Groot Koerkamp}, B. and Klaase, {J. M.} and M. Luyer and Dijkgraaf, {M. G.} and Besselink, {M. G.} and {van Santvoort}, {H. C.} and {de Boer}, {M. T.} and D. Boerma and {van den Boezem}, {P. B.} and {van Dam}, {R. M.} and Dejong, {C. H.} and {van Duyn}, {E. B.} and {van Eijck}, {C. H.} and Gerhards, {M. F.} and {de Hingh}, {I. H.} and G. Kazemier and {de Kleine}, {R. H.} and {van Laarhoven}, {C. J.} and Patijn, {G. A.} and P. Steenvoorde and M. Suker and Hilal, {M. Abu}",
year = "2019",
doi = "10.1002/bjs.11147",
language = "English",
journal = "British Journal of Surgery",
issn = "0007-1323",
publisher = "John Wiley and Sons Ltd",

}

Costs and quality of life in a randomized trial comparing minimally invasive and open distal pancreatectomy (LEOPARD trial). / on behalf of the Dutch Pancreatic Cancer Group and LEOPARD trial collaborators.

In: British Journal of Surgery, 2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Costs and quality of life in a randomized trial comparing minimally invasive and open distal pancreatectomy (LEOPARD trial)

AU - on behalf of the Dutch Pancreatic Cancer Group and LEOPARD trial collaborators

AU - van Hilst, J.

AU - Strating, E. A.

AU - de Rooij, T.

AU - Daams, F.

AU - Festen, S.

AU - Groot Koerkamp, B.

AU - Klaase, J. M.

AU - Luyer, M.

AU - Dijkgraaf, M. G.

AU - Besselink, M. G.

AU - van Santvoort, H. C.

AU - de Boer, M. T.

AU - Boerma, D.

AU - van den Boezem, P. B.

AU - van Dam, R. M.

AU - Dejong, C. H.

AU - van Duyn, E. B.

AU - van Eijck, C. H.

AU - Gerhards, M. F.

AU - de Hingh, I. H.

AU - Kazemier, G.

AU - de Kleine, R. H.

AU - van Laarhoven, C. J.

AU - Patijn, G. A.

AU - Steenvoorde, P.

AU - Suker, M.

AU - Hilal, M. Abu

PY - 2019

Y1 - 2019

N2 - Background: Minimally invasive distal pancreatectomy decreases time to functional recovery compared with open distal pancreatectomy, but the cost-effectiveness and impact on disease-specific quality of life have yet to be established. Methods: The LEOPARD trial randomized patients to minimally invasive (robot-assisted or laparoscopic) or open distal pancreatectomy in 14 Dutch centres between April 2015 and March 2017. Use of hospital healthcare resources, complications and disease-specific quality of life were recorded up to 1 year after surgery. Unit costs of hospital healthcare resources were determined, and cost-effectiveness and cost–utility analyses were performed. Primary outcomes were the costs per day earlier functional recovery and per quality-adjusted life-year. Results: All 104 patients who had a distal pancreatectomy (48 minimally invasive and 56 open) in the trial were included in this study. Patients who underwent a robot-assisted procedure were excluded from the cost analysis. Total medical costs were comparable after laparoscopic and open distal pancreatectomy (mean difference €–427 (95 per cent bias-corrected and accelerated confidence interval €–4700 to 3613; P = 0·839). Laparoscopic distal pancreatectomy was shown to have a probability of at least 0·566 of being more cost-effective than the open approach at a willingness-to-pay threshold of €0 per day of earlier recovery, and a probability of 0·676 per additional quality-adjusted life-year at a willingness-to-pay threshold of €80 000. There were no significant differences in cosmetic satisfaction scores (median 9 (i.q.r. 5·75–10) versus 7 (4–8·75); P = 0·056) and disease-specific quality of life after minimally invasive (laparoscopic and robot-assisted procedures) versus open distal pancreatectomy. Conclusion: Laparoscopic distal pancreatectomy was at least as cost-effective as open distal pancreatectomy in terms of time to functional recovery and quality-adjusted life-years. Cosmesis and quality of life were similar in the two groups 1 year after surgery.

AB - Background: Minimally invasive distal pancreatectomy decreases time to functional recovery compared with open distal pancreatectomy, but the cost-effectiveness and impact on disease-specific quality of life have yet to be established. Methods: The LEOPARD trial randomized patients to minimally invasive (robot-assisted or laparoscopic) or open distal pancreatectomy in 14 Dutch centres between April 2015 and March 2017. Use of hospital healthcare resources, complications and disease-specific quality of life were recorded up to 1 year after surgery. Unit costs of hospital healthcare resources were determined, and cost-effectiveness and cost–utility analyses were performed. Primary outcomes were the costs per day earlier functional recovery and per quality-adjusted life-year. Results: All 104 patients who had a distal pancreatectomy (48 minimally invasive and 56 open) in the trial were included in this study. Patients who underwent a robot-assisted procedure were excluded from the cost analysis. Total medical costs were comparable after laparoscopic and open distal pancreatectomy (mean difference €–427 (95 per cent bias-corrected and accelerated confidence interval €–4700 to 3613; P = 0·839). Laparoscopic distal pancreatectomy was shown to have a probability of at least 0·566 of being more cost-effective than the open approach at a willingness-to-pay threshold of €0 per day of earlier recovery, and a probability of 0·676 per additional quality-adjusted life-year at a willingness-to-pay threshold of €80 000. There were no significant differences in cosmetic satisfaction scores (median 9 (i.q.r. 5·75–10) versus 7 (4–8·75); P = 0·056) and disease-specific quality of life after minimally invasive (laparoscopic and robot-assisted procedures) versus open distal pancreatectomy. Conclusion: Laparoscopic distal pancreatectomy was at least as cost-effective as open distal pancreatectomy in terms of time to functional recovery and quality-adjusted life-years. Cosmesis and quality of life were similar in the two groups 1 year after surgery.

UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85064593411&origin=inward

UR - https://www.ncbi.nlm.nih.gov/pubmed/31012498

U2 - 10.1002/bjs.11147

DO - 10.1002/bjs.11147

M3 - Article

JO - British Journal of Surgery

JF - British Journal of Surgery

SN - 0007-1323

ER -