Abstract
Sentinel lymph node biopsy (SLNB) has already become a standard of care for many cancers. This technique requires a specific organization including a strong collaboration among different departments within a hospital. Thanks to its molecular characteristics, tilmanocept, a new radiotracer indicated in SLNB, could allow hospitals to save time and therefore improve patients workflow especially for ambulatory activities. The aim of this study was to build a model to assess the organizational impact of tilmanocept in the SLNB for breast cancer and melanoma in ambulatory sector. An organizational impact model was developed based on clinical practice via 12 expert interviews (radio pharmacist, surgeon and nuclear medicine physician) using a validated guidebook and completed with data based on literature. This model considers the time spent by a cohort of patients in departments involved in the SLNB procedure such as radiopharmacy service, nuclear medicine service and operating room. The model calculates time-saving by tilmanocept compared to radiotracers used in hospital. This model includes an exhaustive list of time parameters that can be modified according to the practice of each hospital. When real life data are not available, default values based on expert’s opinion and literature are used. A hypothetic cohort of 12 patients (9 with breast cancer and 3 with melanoma) undergoing SLNB per week in ambulatory care was entered in the model. In comparison with nanocolloids of human albumin, tilmanocept allows for saving 540 minutes or 3 additional patients per week eligible for SLNB for breast cancer which represents a 33% increase in ambulatory care. For melanoma, tilmanocept allows for saving 234 minutes or 1 additional patient per week which represents a 38% increase in ambulatory care. Tilmanocept could increase ambulatory activity by reducing the procedure times (preparation, administration, imaging) of the SLNB in breast cancer and melanoma
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