**7. Cost-effectiveness**

It is critical to stress on the cost-effectiveness of integrating RTBs in the management of SRMs. A cost-effectiveness study by Pandharipande et al. [28] showed that a strategy of pretreatment biopsies of SRMs leads to a minimally greater difference of quality-adjusted life expectancy (4 days) than empiric surgery. This is at a lower lifetime cost of (\$3466). Avoiding unnecessary surgery in cases of resecting indolent SRMs is in the interests of both the patient and the healthcare system. With similar outcomes and lower cost, the use of biopsy to triage patients facilitates this.
