BACKGROUND: This study evaluated the cost-effectiveness of combination @entity954 ( @entity954 ) vs definitive chemotherapy and radiotherapy (CR) in clinical stage IIIA @entity1149 ( @entity1149 ) @entity1 at academic and nonacademic centers. METHODS: @entity1 with clinical stage IIIA @entity1149 receiving CR or @entity954 from 1998 to 2010 were identified in the National Cancer Data Base. Propensity score matching on @entity1 , @entity5 , and treatment characteristics was performed. Medicare allowable charges were used for treatment costs. The incremental cost-effectiveness ratio (ICER) was based on probabilistic 5-year survival and calculated as cost per life-year gained. RESULTS: We identified 5,265 CR and @entity954 matched @entity1 pairs. Surgical resection imparted an increased effectiveness of 0.83 life-years, with an ICER of  17,618. Among nonacademic centers, 1,634 matched CR and @entity954 @entity1 demonstrated a benefit with surgical resection of 0.86 life-years gained, for an ICER of  17,124. At academic centers, 3,201 matched CR and @entity954 @entity1 had increased survival of 0.81 life-years with surgical resection, for an ICER of  18,144. Finally, 3,713 @entity954 @entity1 were matched between academic and nonacademic centers. @entity4207 center surgical @entity1 had an increased effectiveness of 1.5 months gained and dominated the model with lower surgical cost estimates associated with lower 30-day mortality rates. CONCLUSIONS: In stage IIIA @entity1149 , the selective addition of surgical resection to CR is cost-effective compared with definitive chemoradiation therapy at nonacademic and academic centers. These conclusions are valid over a range of clinically meaningful variations in cost and treatment outcomes.

The Role of Surgical Resection in Stage IIIA XXXX : A Decision and Cost-Effectiveness Analysis.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity1149 :: ('MESH:D002289', 'Disease') :: ['NSCLC', 'non-small cell lung cancer'] @entity4207 :: ('MESH:D007859', 'Disease') :: ['Academic'] @entity954 :: ('MESH:D016063', 'Disease') :: ['CRS', 'chemotherapy, radiotherapy, and surgical intervention']
@entity1149 :: (MESH:D002289,Disease) :: ['Non-Small Cell Lung Cancer']
