Endobronchial ultrasound-guided transbronchial needle aspiration versus mediastinoscopy for mediastinal staging of lung cancer: A systematic review of economic evaluation studies.

Publisher: Public Library of Science Country of Publication: United States NLM ID: 101285081 Publication Model: eCollection Cited Medium: Internet ISSN: 1932-6203 (Electronic) Linking ISSN: 19326203 NLM ISO Abbreviation: PLoS One Subsets: MEDLINE

Original Publication: San Francisco, CA : Public Library of Science

Endoscopic Ultrasound-Guided Fine Needle Aspiration/*economics ; Mediastinoscopy/*economics ; Neoplasm Staging/*methods; Bronchoscopy/economics ; Bronchoscopy/methods ; Cost-Benefit Analysis ; Endoscopic Ultrasound-Guided Fine Needle Aspiration/methods ; Female ; Humans ; Image-Guided Biopsy/economics ; Image-Guided Biopsy/methods ; Lung Neoplasms/diagnosis ; Lung Neoplasms/pathology ; Male ; Mediastinoscopy/methods ; Mediastinum/diagnostic imaging ; Mediastinum/surgery ; Neoplasm Staging/economics

Introduction: The emergence of endobronchial ultrasound (EBUS) changed the approach to staging lung cancer. As a new method being incorporated, the use of EBUS may lead to a shift in clinical and costs outcomes.
Objective: The aim of this systematic review is to gather information to better understand the economic impact of implementing EBUS.
Methods: This review is reported according to the PRISMA statement and registered on PROSPERO (CRD42019107901). Search keywords were elaborated considering descriptors of terms related to the disease (lung cancer / mediastinal staging of lung cancer) and the technologies of interest (EBUS and mediastinoscopy) combined with a specific economic filter. The literature search was performed in MEDLINE, EMBASE, LILACS, Cochrane Library of Trials, Web of Science, Scopus and National Health System Economic Evaluation Database (NHS EED) of the Center for Reviews and Dissemination (CRD). Screening, selection of articles, data extraction and quality assessment were carried out by two reviewers.
Results: Seven hundred and seventy publications were identified through the database searches. Eight articles were included in this review. All publications are full economic evaluation studies, one cost-effectiveness, three cost-utility, and four cost-minimization analyses. The costs of strategies using EBUS-TBNA were lower than the ones using mediastinoscopy in all studies analyzed. Two of the best quality scored studies demonstrate that the mediastinoscopy strategy is dominated by the EBUS-TBNA strategy.
Conclusion: Information gathered in the eight studies of this systematic review suggest that EBUS is cost-effective compared to mediastinoscopy for mediastinal staging of lung cancer.
Competing Interests: The authors have declared that no competing interests exist.

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Date Created: 20200701 Date Completed: 20200904 Latest Revision: 20200904

20250114

PMC7326228

10.1371/journal.pone.0235479

32603376