Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma
Background & Aims Both hepatic resection and radiofrequency ablation (RFA) are considered curative treatments for hepatocellular carcinoma (HCC), but their economic impact still remains not determined. Aim of the present study was to analyze the cost-effectiveness (CE) of these two strategies in...
Gespeichert in:
| Veröffentlicht in: | Journal of hepatology 2013-08, Vol.59 (2), p.300-307 |
|---|---|
| Hauptverfasser: | , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 307 |
|---|---|
| container_issue | 2 |
| container_start_page | 300 |
| container_title | Journal of hepatology |
| container_volume | 59 |
| creator | Cucchetti, Alessandro Piscaglia, Fabio Cescon, Matteo Colecchia, Antonio Ercolani, Giorgio Bolondi, Luigi Pinna, Antonio D |
| description | Background & Aims Both hepatic resection and radiofrequency ablation (RFA) are considered curative treatments for hepatocellular carcinoma (HCC), but their economic impact still remains not determined. Aim of the present study was to analyze the cost-effectiveness (CE) of these two strategies in early stage HCC (Milan criteria). Methods As first step, a meta-analysis of the pertinent literature of the last decade was performed. Seventeen studies fulfilled the inclusion criteria: 3996 patients underwent resection and 4424 underwent RFA for early HCC. Data obtained from the meta-analysis were used to construct a Markov model. Costs were assessed from the health care provider perspective. A Monte Carlo probabilistic sensitivity analysis was used to estimate outcomes with distribution samples of 1000 patients for each treatment arm. Results In a 10-year perspective, for very early HCC (single nodule |
| doi_str_mv | 10.1016/j.jhep.2013.04.009 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1411629200</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0168827813002626</els_id><sourcerecordid>1411629200</sourcerecordid><originalsourceid>FETCH-LOGICAL-c510t-49906e741f3438911cefdab34aa6216a8fc82649e741c178408882ba58f9cd4e3</originalsourceid><addsrcrecordid>eNp9kcGKFDEQhoMou-O4L-BB-uil26okm0mDCDK4q7DgQT2HTLqCaXs6Y9I9MG9v2l49ePAUinz1U_UVYy8RGgRUb_qm_06nhgOKBmQD0D5hG1QANSiJT9mmQLrWfKev2fOcewAQ0Mords2FAqFUu2HnfcxTTd6Tm8KZRsq5ir4quXYKrkqUl484VmdKec7ViZKbJztSLEWyXYg-0c-ZRnep7GGwv1kfU0U2DZc1JzoahnmwqXI2uTDGo33Bnnk7ZLp5fLfs292Hr_uP9cPn-0_79w-1u0WYatm2oGgn0QspdIvoyHf2IKS1iqOy2jvNlWwXxOFOS9Ba84O91b51nSSxZa_X3FOKZco8mWPIyzjrBgYlouItL2a2jK-oSzHnRN6cUjjadDEIZvFterP4NotvA9IU36Xp1WP-fDhS97flj-ACvF0BKlueAyWTXSi2qAupmDVdDP_Pf_dPuxvCGJwdftCFch_nNBZ_Bk3mBsyX5eLLwVEAcMWV-AUb5qjR</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1411629200</pqid></control><display><type>article</type><title>Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Cucchetti, Alessandro ; Piscaglia, Fabio ; Cescon, Matteo ; Colecchia, Antonio ; Ercolani, Giorgio ; Bolondi, Luigi ; Pinna, Antonio D</creator><creatorcontrib>Cucchetti, Alessandro ; Piscaglia, Fabio ; Cescon, Matteo ; Colecchia, Antonio ; Ercolani, Giorgio ; Bolondi, Luigi ; Pinna, Antonio D</creatorcontrib><description>Background & Aims Both hepatic resection and radiofrequency ablation (RFA) are considered curative treatments for hepatocellular carcinoma (HCC), but their economic impact still remains not determined. Aim of the present study was to analyze the cost-effectiveness (CE) of these two strategies in early stage HCC (Milan criteria). Methods As first step, a meta-analysis of the pertinent literature of the last decade was performed. Seventeen studies fulfilled the inclusion criteria: 3996 patients underwent resection and 4424 underwent RFA for early HCC. Data obtained from the meta-analysis were used to construct a Markov model. Costs were assessed from the health care provider perspective. A Monte Carlo probabilistic sensitivity analysis was used to estimate outcomes with distribution samples of 1000 patients for each treatment arm. Results In a 10-year perspective, for very early HCC (single nodule <2 cm) in Child–Pugh class A patients, RFA provided similar life-expectancy and quality-adjusted life-expectancy at a lower cost than resection and was the most cost-effective therapeutic strategy. For single HCCs of 3–5 cm, resection provided better life-expectancy and was more cost-effective than RFA, at a willingness-to-pay above € 4200 per quality-adjusted life-year. In the presence of two or three nodules ⩽3 cm, life-expectancy and quality-adjusted life-expectancy were very similar between the two treatments, but cost-effectiveness was again in favour of RFA. Conclusions For very early HCC and in the presence of two or three nodules ⩽3 cm, RFA is more cost-effective than resection; for single larger early stage HCCs, surgical resection remains the best strategy to adopt as a result of better survival rates at an acceptable increase in cost.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2013.04.009</identifier><identifier>PMID: 23603669</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Carcinoma, Hepatocellular - mortality ; Carcinoma, Hepatocellular - pathology ; Carcinoma, Hepatocellular - surgery ; Catheter Ablation - economics ; Catheter Ablation - methods ; Cirrhosis ; Cost-Benefit Analysis ; Cost-effectiveness ; Gastroenterology and Hepatology ; Hepatectomy - economics ; Hepatectomy - methods ; Hepatic resection ; Hepatocellular carcinoma ; Humans ; Life Expectancy ; Liver Neoplasms - mortality ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Markov Chains ; Meta-analysis ; Monte Carlo Method ; Quality-Adjusted Life Years ; Radio Waves - therapeutic use ; Radiofrequency ablation</subject><ispartof>Journal of hepatology, 2013-08, Vol.59 (2), p.300-307</ispartof><rights>European Association for the Study of the Liver</rights><rights>2013 European Association for the Study of the Liver</rights><rights>Copyright © 2013 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c510t-49906e741f3438911cefdab34aa6216a8fc82649e741c178408882ba58f9cd4e3</citedby><cites>FETCH-LOGICAL-c510t-49906e741f3438911cefdab34aa6216a8fc82649e741c178408882ba58f9cd4e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0168827813002626$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23603669$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cucchetti, Alessandro</creatorcontrib><creatorcontrib>Piscaglia, Fabio</creatorcontrib><creatorcontrib>Cescon, Matteo</creatorcontrib><creatorcontrib>Colecchia, Antonio</creatorcontrib><creatorcontrib>Ercolani, Giorgio</creatorcontrib><creatorcontrib>Bolondi, Luigi</creatorcontrib><creatorcontrib>Pinna, Antonio D</creatorcontrib><title>Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>Background & Aims Both hepatic resection and radiofrequency ablation (RFA) are considered curative treatments for hepatocellular carcinoma (HCC), but their economic impact still remains not determined. Aim of the present study was to analyze the cost-effectiveness (CE) of these two strategies in early stage HCC (Milan criteria). Methods As first step, a meta-analysis of the pertinent literature of the last decade was performed. Seventeen studies fulfilled the inclusion criteria: 3996 patients underwent resection and 4424 underwent RFA for early HCC. Data obtained from the meta-analysis were used to construct a Markov model. Costs were assessed from the health care provider perspective. A Monte Carlo probabilistic sensitivity analysis was used to estimate outcomes with distribution samples of 1000 patients for each treatment arm. Results In a 10-year perspective, for very early HCC (single nodule <2 cm) in Child–Pugh class A patients, RFA provided similar life-expectancy and quality-adjusted life-expectancy at a lower cost than resection and was the most cost-effective therapeutic strategy. For single HCCs of 3–5 cm, resection provided better life-expectancy and was more cost-effective than RFA, at a willingness-to-pay above € 4200 per quality-adjusted life-year. In the presence of two or three nodules ⩽3 cm, life-expectancy and quality-adjusted life-expectancy were very similar between the two treatments, but cost-effectiveness was again in favour of RFA. Conclusions For very early HCC and in the presence of two or three nodules ⩽3 cm, RFA is more cost-effective than resection; for single larger early stage HCCs, surgical resection remains the best strategy to adopt as a result of better survival rates at an acceptable increase in cost.</description><subject>Carcinoma, Hepatocellular - mortality</subject><subject>Carcinoma, Hepatocellular - pathology</subject><subject>Carcinoma, Hepatocellular - surgery</subject><subject>Catheter Ablation - economics</subject><subject>Catheter Ablation - methods</subject><subject>Cirrhosis</subject><subject>Cost-Benefit Analysis</subject><subject>Cost-effectiveness</subject><subject>Gastroenterology and Hepatology</subject><subject>Hepatectomy - economics</subject><subject>Hepatectomy - methods</subject><subject>Hepatic resection</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Life Expectancy</subject><subject>Liver Neoplasms - mortality</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Markov Chains</subject><subject>Meta-analysis</subject><subject>Monte Carlo Method</subject><subject>Quality-Adjusted Life Years</subject><subject>Radio Waves - therapeutic use</subject><subject>Radiofrequency ablation</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcGKFDEQhoMou-O4L-BB-uil26okm0mDCDK4q7DgQT2HTLqCaXs6Y9I9MG9v2l49ePAUinz1U_UVYy8RGgRUb_qm_06nhgOKBmQD0D5hG1QANSiJT9mmQLrWfKev2fOcewAQ0Mords2FAqFUu2HnfcxTTd6Tm8KZRsq5ir4quXYKrkqUl484VmdKec7ViZKbJztSLEWyXYg-0c-ZRnep7GGwv1kfU0U2DZc1JzoahnmwqXI2uTDGo33Bnnk7ZLp5fLfs292Hr_uP9cPn-0_79w-1u0WYatm2oGgn0QspdIvoyHf2IKS1iqOy2jvNlWwXxOFOS9Ba84O91b51nSSxZa_X3FOKZco8mWPIyzjrBgYlouItL2a2jK-oSzHnRN6cUjjadDEIZvFterP4NotvA9IU36Xp1WP-fDhS97flj-ACvF0BKlueAyWTXSi2qAupmDVdDP_Pf_dPuxvCGJwdftCFch_nNBZ_Bk3mBsyX5eLLwVEAcMWV-AUb5qjR</recordid><startdate>20130801</startdate><enddate>20130801</enddate><creator>Cucchetti, Alessandro</creator><creator>Piscaglia, Fabio</creator><creator>Cescon, Matteo</creator><creator>Colecchia, Antonio</creator><creator>Ercolani, Giorgio</creator><creator>Bolondi, Luigi</creator><creator>Pinna, Antonio D</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130801</creationdate><title>Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma</title><author>Cucchetti, Alessandro ; Piscaglia, Fabio ; Cescon, Matteo ; Colecchia, Antonio ; Ercolani, Giorgio ; Bolondi, Luigi ; Pinna, Antonio D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c510t-49906e741f3438911cefdab34aa6216a8fc82649e741c178408882ba58f9cd4e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Carcinoma, Hepatocellular - mortality</topic><topic>Carcinoma, Hepatocellular - pathology</topic><topic>Carcinoma, Hepatocellular - surgery</topic><topic>Catheter Ablation - economics</topic><topic>Catheter Ablation - methods</topic><topic>Cirrhosis</topic><topic>Cost-Benefit Analysis</topic><topic>Cost-effectiveness</topic><topic>Gastroenterology and Hepatology</topic><topic>Hepatectomy - economics</topic><topic>Hepatectomy - methods</topic><topic>Hepatic resection</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Life Expectancy</topic><topic>Liver Neoplasms - mortality</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Markov Chains</topic><topic>Meta-analysis</topic><topic>Monte Carlo Method</topic><topic>Quality-Adjusted Life Years</topic><topic>Radio Waves - therapeutic use</topic><topic>Radiofrequency ablation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cucchetti, Alessandro</creatorcontrib><creatorcontrib>Piscaglia, Fabio</creatorcontrib><creatorcontrib>Cescon, Matteo</creatorcontrib><creatorcontrib>Colecchia, Antonio</creatorcontrib><creatorcontrib>Ercolani, Giorgio</creatorcontrib><creatorcontrib>Bolondi, Luigi</creatorcontrib><creatorcontrib>Pinna, Antonio D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cucchetti, Alessandro</au><au>Piscaglia, Fabio</au><au>Cescon, Matteo</au><au>Colecchia, Antonio</au><au>Ercolani, Giorgio</au><au>Bolondi, Luigi</au><au>Pinna, Antonio D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2013-08-01</date><risdate>2013</risdate><volume>59</volume><issue>2</issue><spage>300</spage><epage>307</epage><pages>300-307</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><abstract>Background & Aims Both hepatic resection and radiofrequency ablation (RFA) are considered curative treatments for hepatocellular carcinoma (HCC), but their economic impact still remains not determined. Aim of the present study was to analyze the cost-effectiveness (CE) of these two strategies in early stage HCC (Milan criteria). Methods As first step, a meta-analysis of the pertinent literature of the last decade was performed. Seventeen studies fulfilled the inclusion criteria: 3996 patients underwent resection and 4424 underwent RFA for early HCC. Data obtained from the meta-analysis were used to construct a Markov model. Costs were assessed from the health care provider perspective. A Monte Carlo probabilistic sensitivity analysis was used to estimate outcomes with distribution samples of 1000 patients for each treatment arm. Results In a 10-year perspective, for very early HCC (single nodule <2 cm) in Child–Pugh class A patients, RFA provided similar life-expectancy and quality-adjusted life-expectancy at a lower cost than resection and was the most cost-effective therapeutic strategy. For single HCCs of 3–5 cm, resection provided better life-expectancy and was more cost-effective than RFA, at a willingness-to-pay above € 4200 per quality-adjusted life-year. In the presence of two or three nodules ⩽3 cm, life-expectancy and quality-adjusted life-expectancy were very similar between the two treatments, but cost-effectiveness was again in favour of RFA. Conclusions For very early HCC and in the presence of two or three nodules ⩽3 cm, RFA is more cost-effective than resection; for single larger early stage HCCs, surgical resection remains the best strategy to adopt as a result of better survival rates at an acceptable increase in cost.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>23603669</pmid><doi>10.1016/j.jhep.2013.04.009</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0168-8278 |
| ispartof | Journal of hepatology, 2013-08, Vol.59 (2), p.300-307 |
| issn | 0168-8278 1600-0641 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1411629200 |
| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Carcinoma, Hepatocellular - mortality Carcinoma, Hepatocellular - pathology Carcinoma, Hepatocellular - surgery Catheter Ablation - economics Catheter Ablation - methods Cirrhosis Cost-Benefit Analysis Cost-effectiveness Gastroenterology and Hepatology Hepatectomy - economics Hepatectomy - methods Hepatic resection Hepatocellular carcinoma Humans Life Expectancy Liver Neoplasms - mortality Liver Neoplasms - pathology Liver Neoplasms - surgery Markov Chains Meta-analysis Monte Carlo Method Quality-Adjusted Life Years Radio Waves - therapeutic use Radiofrequency ablation |
| title | Cost-effectiveness of hepatic resection versus percutaneous radiofrequency ablation for early hepatocellular carcinoma |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T08%3A54%3A24IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Cost-effectiveness%20of%20hepatic%20resection%20versus%20percutaneous%20radiofrequency%20ablation%20for%20early%20hepatocellular%20carcinoma&rft.jtitle=Journal%20of%20hepatology&rft.au=Cucchetti,%20Alessandro&rft.date=2013-08-01&rft.volume=59&rft.issue=2&rft.spage=300&rft.epage=307&rft.pages=300-307&rft.issn=0168-8278&rft.eissn=1600-0641&rft_id=info:doi/10.1016/j.jhep.2013.04.009&rft_dat=%3Cproquest_cross%3E1411629200%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1411629200&rft_id=info:pmid/23603669&rft_els_id=S0168827813002626&rfr_iscdi=true |