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Table 2 Yearly input parameters of the lifetime state transition model

From: Cost-effectiveness of the implementation of [68Ga]Ga-PSMA-11 PET/CT at initial prostate cancer staging

Parameter Value Distribution (SE) Source
Lifetime state transition model probabilities
Probability BCR in the NEOD-N1 (pBCR) 0.45 (Gompertz; Rate 0.66, shape -0.38) Normal Mandel et al. [21]
Percentage with BCR to salvage 0.63 Beta (0.063) De Bruycker et al. [22]
N1-NEOD to salvage pBCR * Percentage with BCR to salvage   
N1-NEOD to palliative pBCR * (1-Percentage with BCR to salvage)   
Salvage to palliative 0.31 Beta (0.031) Decaestecker et al. [23]
Cancer mortality (palliative) 0.032 Beta (0.0032) Tumati et al. [24]
Cancer mortality (false palliative) 0.032 Beta (0.0032) Assumption: equals Cancer Mortality
All-Cause mortality Standard mortality rates age 69 and higher Fixed CBS [25]
[68Ga]Ga-PSMA-11 PET/CT probabilities
pN0 to palliative (FP) 0 Fixed PSMA PET/CT indicates multiple LNMs in N0 patients
pN1lim to palliative (FP) 0.027 Beta (0.027) PSMA PET/CT indicates multiple LNMs in N1lim
Costs (€)
NEOD-N0 and N1 108 Gamma (€11) De Rooij et al. [26]
(False) palliative 4,6131 Gamma (€1,153) Schwenk et al. [27]
FK [28]
Salvage 8,0222 Gamma (€802) Schwenk et al. [27]
Palliative to death (transition cost) 16,720 Gamma (€1,672) Tien et al. [29]
Utilities (QALY)
NEOD-N0 and N1 0.813 Beta (0.081) Versteegh et al. [30]
Scholte et al. [10]    
(False) palliative 0.67 Beta (0.067) Stewart et al. [31]; Asymptomatic spread
Salvage 0.77 Beta (0.077) Heijnsdijk et al. [32]; RT
  1. All-cause mortality was derived from the Dutch public data [25] regarding mortality rates for age 69 and higher in 2019. The transition parameters BCR from NOED N1, salvage to palliative and palliative to death (Cancer mortality) were determined by fitting a Gompertz or exponential distribution on the Kaplan Meier curves, using webplotdigitizer [33]. All other transitions were derived from literature. BCR biochemical recurrence, CBS centraal bureau voor statistiek (Dutch national price index), FP false positive, LNM lymph node metastases, N0 no lymph node metastasis, N1lim limited lymph nodes metastasis defined as less than or equal to four pelvic lymph node metastasis, NOED No evidence of disease, pBCR probability on biochemical recurrence, SE standard error, PET/CT positron emission tomography/computed tomography, PSMA prostate specific membrane antigen.
  2. 1Cost of palliative therapy was assumed to be the costs of 66Gr Radiotherapy and 4 shots Goserilin
  3. 2Cost of salvage treatment was assumed to be the mean cost of all radiotherapy options described in Schwenk et al. [27]
  4. 3Utility was estimated using the mean utility for men aged 70–80 and a fixed correction for long-term primary treatment complications as calculated by Scholte et al. [10]