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Efficacy, safety and cost-effectiveness of 5-fluorouracil versus interferon α-2b as adjuvant therapy after surgery in ocular surface squamous neoplasia in a southern European tertiary hospital

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Abstract

Purpose

To analyze the efficacy, safety and cost-effectiveness of adjuvant therapy with 5-fluorouracil (5-FU) compared to interferon α-2b (IFNα-2b) after surgery in ocular surface squamous neoplasia (OSSN).

Methods

Retrospective study that included patients diagnosed with OSSN, who underwent surgical excision followed by adjuvant therapy with IFN α-2b (Group A) or 5-FU (Group B), in a tertial referral hospital. Clinical data collected included: demographics, risk factors, appearance, size and location of the lesions, slit-lamp examination, anterior segment optical coherence tomography, iconography and histological classification of subtypes of OSSN. Costs derived from surgery and adjuvant therapy were noted. Resolution of the lesion, recurrences and adverse events were studied. Cost-effectiveness analysis was performed with the incremental cost-effectiveness index (CEI).

Results

54 cases of 54 patients were included, with a mean age of 74.4 years (range 28–109). 30 were male (55.6%), and predominantly Caucasian (79.6%). The main risk factor was prolonged sun exposure (79.6%). Leukoplakic appearance (48.1%), location in bulbar conjunctiva (48.2%) and T3 (46.3%) stage were the most common clinical features. Histologically, the percentage of CIN I, CIN II, CIN III and SCC were 25.9%, 29.6%, 40.7% and 3.7%, respectively. Complete resolution was obtained in 74.1% and tolerance was overall positive. The cost was significantly higher for IFNα (1025€ ± 130.68€) compared to 5-FU (165.57€ ± 45.85 €) (p 0.001). The CEI was − 247.14€.

Conclusions

Both 5-FU and IFN α-2b are effective and present a good security profile as adjuvant therapies after surgery in OSSN. Although presenting slightly more ocular complications, 5-FU can be considered more cost-effective than IFN α-2b.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. University Hospital Fundación Jiménez Diaz, Avenida Reyes Católicos 2, 28040, Madrid, Spain

    José Javier San Román Llorens, Marta Fernández-Gurria, June Artaechevarria Artieda, Nicolas Alejandre Alba, Blanca García Sandoval & Ignacio Jiménez-Alfaro Morote

  2. Ruber Juan Bravo Hospital, Madrid, Spain

    José Javier San Román Llorens, Blanca García Sandoval & Ignacio Jiménez-Alfaro Morote

Authors
  1. José Javier San Román Llorens
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  2. Marta Fernández-Gurria
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  3. June Artaechevarria Artieda
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  4. Nicolas Alejandre Alba
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  5. Blanca García Sandoval
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  6. Ignacio Jiménez-Alfaro Morote
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Contributions

JJ San Roman Llorens, M Fernandez Gurría wrote the main manuscript. J Artaechevarria translated it. All authors reviewed the manuscript

Corresponding author

Correspondence to José Javier San Román Llorens.

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The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This retrospective study was approved by the Ethics Committee of Fundación Jiménez Díaz University Hospital, and followed the tenets of the Declaration of Helsinki and the data protection law of the European Union.

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Informed consent was obtained from all individual participants included in the study.

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San Román Llorens, J.J., Fernández-Gurria, M., Artaechevarria Artieda, J. et al. Efficacy, safety and cost-effectiveness of 5-fluorouracil versus interferon α-2b as adjuvant therapy after surgery in ocular surface squamous neoplasia in a southern European tertiary hospital. Int Ophthalmol 44, 184 (2024). https://doi.org/10.1007/s10792-024-03105-w

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