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Costo efectividad de la cirugía reductora de riesgo en trompas y ovarios en casos con mutación del gen BRCA1 en Colombia
Cost-effectiveness of risk-reducing salpingo-oophorectomy in cases of BRCA1 gene mutation in Colombia
DOI:
https://doi.org/10.15446/rsap.v20n2.64866Palabras clave:
Evaluación de costo-efectividad, neoplasias ováricas, neoplasias de la mama, ovariectomía, medicina preventiva (es)Cost-benefit analysis, ovarian neoplasms, breast neoplasms, ovariectomy, prophylactic surgical procedures (en)
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Objetivo Evaluar la utilidad de la cirugía reductora de riesgo en trompas y ovarios en casos con mutación del gen BRCA1 en Colombia
Material y Métodos Análisis de costo-efectividad en el que se incorporan tres procesos: a. Pacientes con pruebas de tamización para cáncer de mama y ovario. b. cirugía reductora de riesgo en trompas y ovarios c. cirugía reductora de riesgo en trompas y ovarios con mastectomía bilateral. Se evalúa como desenlace la ganancia en años de supervivencia.
Resultados La cohorte con cirugía reductora de riesgo en trompas y ovarios y mastectomía bilateral es la de mayor ganancia con 13 años mientras que la cirugía reductora de riesgo en trompas y ovarios gana 4,95 años con respecto al grupo de seguimiento.
Conclusiones Las tres opciones evaluadas son aceptables, pero de ellas la de mayor ganancia en la supervivencia es la combinación de cirugía reductora de riesgo en trompas y ovarios con mastectomía bilateral.
Objective To assess the usefulness of risk reduction salpingo-oophorectomy in cases with mutation of the BRCA1 gene in Colombia.
Material and Methods Cost-effectiveness analysis in which three processes are incorporated: a. Patients with screening tests for breast and ovarian cancer. b. Risk reduction surgery in the fallopian tubes and ovaries c. Reductive surgery in the fallopian tubes and ovaries with bilateral mastectomy. The outcome is evaluated as the gain in years of survival.
Results The cohort with risk reduction surgery in the fallopian tubes and ovaries and bilateral mastectomy is the one with the highest gain with 13 years, while the risk reduction surgery in the fallopian tubes and ovaries gain 4.95 years with respect to the follow-up group.
Conclusions The three options evaluated are acceptable, but of them the one with the greatest gain in survival is the combination of risk-reducing surgery in the fallopian tubes and ovaries with bilateral mastectomy.
Referencias
Levine DA, Argenta PA, Yee CJ, Marshall DS, Olvera N, Bogomolniy F, et al. Fallopian tube and primary peritoneal carcinomas associated with BRCA mutations. J Clin Oncol. 2003; 21:4222–4227.
Miki Y, Swensen J, Shattuck-Eidens D, Futreal PA, Harshman K et al. A Strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science. 1994; 266 (5182):66-71.
Wooster R, Weber BL. Breast and ovarian cancer. N Engl J Med. 2003;348 (23):2339-47.
Antoniou A, Pharoah PD, Narod S, Risch HA, Eyfjord JE, et al. Average Risks of Breast and Ovarian Cancer Associated with BRCA1 or BRCA2 Mutations Detected in Case Series Unselected for Family History: A Combined Analysis of 22 Studies. Am J Hum Genet. 2003; 72(5):1117-1130.
Chen S, Parmigiani G. Meta-analysis of BRCA1 and BRCA2 penetrance. J Clin Oncol. 2007;25(11):1329-33.
Finch A, Evans G, Narod SA. BRCA carriers, prophylactic salpingo- oophorectomy and menopause: clinical management considerations and recommendations. Women's Health. 2012; 8(5): 543–555.
Oliver P MR, Magriñá J, Tejerizo A, Jimenez JS. Prohylactic salpingectomy and Prohylactic salpingoophorectomy for adnexal high-grade serous epithelial carcinoma: a reappraisal .Surgical Oncology. 2015;24: 335-334.
Legare RD: Genetics: Predisposition and Management. Clinical Obstetrics and Gynecology. 2011; 54(1):180–190.
Parada L, Taborda A. Modelos de evaluación económica: su aplicación en las decisiones sanitarias. Revista Colombiana de Psiquiatría. 2011; 40 (2): 352-362.
WHO Commission on Macroeconomics and Health. Macroeconomics and health: investing in health for economic development. Report of the Commission on Macroeconomics and Health. Geneva: WHO; 2001.
Faria R, Mejía A (eds). Documentos técnicos de apoyo a la construcción del caso de referencia colombiano para la evaluación económica en salud. Bogotá DC: Instituto de Evaluación Tecnológica - IETS; 2014.
Schrag D Kuntz KM., Garber JE, Weeks JC. Decision analysis - effects of prophylactic mastectomy and oophorectomy on life expectancy among women with brca1 or brca2 mutations. N Engl J Med. 1997; 336:1465-1471.
Grann VR, Patel PR, Jacobson JS, Warner E, Heitjan DF Comparative effectiveness of screening and prevention strategies among BRCA1/2-affected mutation carriers. Breast Cancer Res Treat. 2011; 125(3):837–847.
Instituto de Evaluación Tecnológica en Salud. Manual para la elaboración de evaluaciones económicas en salud. Bogotá D.C.: IETS; 2014.
Devlin N, Parkin D. Does NICE have a cost-effectiveness threshold and what other factors influence its decisions? A binary choice analysis. Health Econ. 2004 May; 13(5):437-452.
Sigal BM, Munoz DF, Kurian AW, Plevritis SK.A simulation model to predict the impact of prophylactic surgery and screening on the life expectancy of BRCA1 and BRCA2 mutation carriers. Cancer Epidemiol Biomarkers Prev. 2012 Jul; 21(7):1066-1077.
González MA. Evaluación de la utilidad de un programa de cribado mamográfico en Bogotá, Colombia. Revista de Salud Pública (Bogotá) 2012; 4(1):41-52.
National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology. Genetic/ Familial high risk assessment Breast and ovarian. Version 2.2015 https://goo.gl/6tKX2y. Consultado en enero de 2016.
Greenwald P, Nasca PC, Lawrence CE, et al. Estimated effect of breast self-examination and routine physician examinations on breast-cancer mortality. N Engl J Med. 1978; 299:271-273.
Kerlikowske K, Grady D, Rubin SM, Sandrock C, Ernster VL. Efficacy of screening mammography: a meta-analysis. JAMA. 1995;273:149-154.
Bourne TH, Whitehead MI, Campbell S, Royston P, Bhan V, Collins WP. Ultrasound screening for familial ovarian cancer. Gynecol Oncol. 1991; 43:92-97.
Eldar S, Meguid MM, Beatty JD. Cancer of the breast after prophylactic subcutaneous mastectomy. Am J Surg. 1984; 148:692-693.
Antoniou A,. Pharoah PD P, Narod S, Risch H.A, Eyfjord J E, Loman JN, et al. Average Risks of Breast and Ovarian Cancer Associated with BRCA1 or BRCA2 Mutations Detected in Case Series Unselected for Family History: A Combined Analysis of 22 Studies. Am. J. Hum. Genet. 2003; 72:1117–1130.24.
Salhab M, Bismohun S, Mokbel K. Risk-reducing strategies for women carrying brca1/2 mutations with a focus on prophylactic Surgery. BMC Womens Health. 2010; 10:28.
Gaffney DK, Brohet RM, Lewis CM, Holden JA, Buys SS, Neuhausen SL, et al: Response to radiation therapy and prognosis in breast cancer patients with BRCA1 and BRCA2 mutations. Radiother Oncol. 1998, 47:129-136.
Verhoog LC, Brekelmans CT, Seynaeve C, van den Bosch LM, Dahmen G, van Geel AN, et al: Survival and tumour characteristics of breast-cancer patients with germline mutations of BRCA1. Lancet. 1998, 351:316-321.
Grann VR, Panageas KS, Whang W, Antman KH, Neugut AI: Decision analysis of prophylactic mastectomy and oophorectomy in BRCA1- positive or BRCA2-positive patients. J Clin Oncol. 1998, 16:979-985.
Petrucelli N, Daly MB, Feldman GL. BRCA1 and BRCA2 Hereditary Breast and Ovarian Cancer. GeneReviews®. [Internet]. Disponible en: https://goo.gl/VtGvZC.
Robles SC, Galanis E. El cáncer de mama en América Latina y el caribe: informar sobre las opciones. Organización Panamericana de la Salud; 2001.
Ramsey SD, McIntosh M, Etzioni R, Urban N. Simulation modeling of outcomes and cost effectiveness. Hematol Oncol Clin North Am. 2000 Aug; 14(4):925-938.
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