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.

中文翻译：

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支气管内超声引导下经支气管针吸术与纵隔镜检查对肺癌纵隔分期的影响：经济评价研究的系统综述。

介绍

支气管内超声（EBUS）的出现改变了肺癌分期的方法。作为一种新的方法，EBUS的使用可能导致临床和成本结果的转变。

目的

此系统审查的目的是收集信息，以更好地了解实施EBUS的经济影响。

方法

此评论根据PRISMA声明进行报告，并在PROSPERO（CRD42019107901）上注册。精心设计了搜索关键字，考虑了与疾病相关的术语（肺癌/肺癌纵隔分期）以及相关技术（EBUS和纵隔镜）与特定的经济过滤器相结合的描述词。在MEDLINE，EMBASE，LILACS，Cochrane试用图书馆，科学网络，Scopus和评论与传播中心（CRD）的国家卫生系统经济评估数据库（NHS EED）中进行文献检索。两名审稿人进行了筛选，文章选择，数据提取和质量评估。

结果

通过数据库搜索确定了770个出版物。八篇文章被纳入该评价。所有出版物都是全面的经济评估研究，其中一项成本效益，三项成本效用和四项成本最小化分析。在所有分析的研究中，使用EBUS-TBNA进行策略的成本均低于使用纵隔镜进行策略的成本。两项质量最高的研究表明，纵隔镜检查策略以EBUS-TBNA策略为主。

结论

在这项系统评价的八项研究中收集的信息表明，与纵隔镜相比，EBUS在肺癌纵隔分期方面具有成本效益。