|
Development of malignancy (%)
|
|
Cystic lesions that are non-mucinous (e. g., serous cystadenoma, pseudocyst)
|
All |
30 |
10 – 60 |
|
Biological aggressiveness of mucinous cysts/ branch type IPMN (at presentation)
|
All |
|
|
| Benign |
|
65 |
0 – 100 |
| Borderline/indolent |
|
20 |
0 – 100 |
| Malignant |
|
15 |
0 – 100 |
|
Probability of asymptomatic mucinous cyst or side-branch IPMN becoming symptomatic (annual)
|
All |
|
|
| Cyst is ≤ 3 cm |
|
2 |
0 – 5 |
| Cyst is > 3 cm |
|
10 |
1 – 15 |
|
Probability of benign mucinous cystic lesion/branch type IPMN transitioning from benign to malignant (years)
|
|
|
|
| Cyst is ≤ 3 cm |
|
2.5 |
0 – 50 |
| Cyst is > 3 cm |
|
5 |
0 – 50 |
|
Probability of malignant cysts becoming symptomatic (annual)
|
|
25 |
0 – 100 |
|
Performance characteristics of diagnostic tests (%)
|
|
Differentiating mucinous from non-mucinous cysts
|
| MRI/CT (sensitivity) |
All |
70 |
50 – 100 |
| CEA + cytology (sensitivity) |
III, IV |
80 |
50 – 100 |
| CEA + cytology (specificity) |
III, IV |
65 |
0 – 80 |
| PathFinder TG + CEA + cytology (sensitivity) |
IV |
68 |
50 – 80 |
| PathFinder TG + CEA + cytology (specificity) |
IV |
90 |
70 – 95 |
|
Distinguishing aggressive from non-aggressive cysts
|
| PathFinder sensitivity |
IV |
82 |
70 – 90 |
| PathFinder specificity |
IV |
85 |
70 – 90 |
|
Mortality and utility (used in calculating QALY)
|
|
Perioperative mortality (years)
|
|
3 |
1 – 15 |
|
Mortality from invasive malignant cysts (years)
|
|
10 |
0 – 5 |
| Normal (%) |
|
1.0 |
(N/A) |
| Incidental cyst (%) |
|
1.0 |
0.75 – 1 |
| Symptomatic cyst (%) |
|
0.95 |
0.7 – 1 |
| Postoperative state (%) |
|
0.95 |
0.7 – 1 |
| Early cancer (%) |
|
0.9 |
0.68 – 1 |
| Advanced cancer (%) |
|
0.5 |
0.38 – 1 |
|
Costs ($)
|
|
Cross-sectional imaging (CT/ MRI)
|
All |
1000 |
(± 250) |
|
EUS-FNA (including cost of sedation with monitored anesthesia care + CEA + cytology)
|
III, IV |
1525 |
675 – 2675 |
|
Pancreatic surgery
|
|
40 000 |
(± 10 000) |
|
Treatment for advanced malignancy – annual (e. g., chemotherapy and palliative care)
|
|
50 000 |
(± 12 500) |
|
PathFinder TG testing
|
IV |
3100 |
2500 – 5000 |
|
Discount rate (%)
(Correction for inflation/cost increases)
|
|
3 |
0 – 7 |
