Cost-effectiveness comparison of four treatment strategies for primary liver cancer

Abstract

Abstract: Objective To compare the prognosis and cost of four treatment strategies for patients with primary liver cancer (PLC), so as to provide reference for patients to select treatment schemes. Methods The clinical data of 644 patients with PLC primarily diagnosed in Beijing You'an Hospital Affiliated to Capital Medical University from January 1, 2014 to December 31, 2018 were retrospectively analyzed. According to different treatment methods, they were divided into four groups: Hepatectomy (LR) group, transcatheter arterial chemoembolization (TACE) group, TACE combined with radiofrequency ablation (RFA) group, and symptomatic treatment group. The survival rate and prognostic risk factors of the four treatment schemes were compared, and the cost-effectiveness analysis was carried out. Results The 1- to 5- year overall survival rates of TACE combined with RFA group were significantly better than that of the other three groups (P<0.05) (LR group: 58.33%, 27.08%, 14.58%, 4.17%, 2.08%; TACE group: 71.23 %, 53.42%, 35.62%, 24.66%, 12.33%; TACE combined with RFA group: 75.30%, 58.43%, 45.48%, 29.22%, 17.17%; symptomatic treatment group: 28.89%, 15.56%, 0.00%, 0.00%, 0.00%, respectively). Treatment, BCLC stage, ascites and hepatic encephalopathy were independent prognostic factors affecting the overall survival rate. The average treatment costs of each time in the four groups were ￥72201.00±113067.69 in LR group, ￥37302.35±34759.82 in TACE group, ￥41163.46±36920.18 in TACE+RFA group, and ￥35968.44±25546.05 in symptomatic treatment group, which had no statistically significant diference (P<0.001). The 5-year survival rate of four treatment schemes was used as the effectiveness for cost-effectiveness analysis. Because no patients in the symptomatic treatment group survived to 5 years, the cost-effectiveness ratios of the other three treatment groups were as follows: LR group: 34712.02; TACE group: 3025.33; TACE+RFA group: 2397.41, and the difference was statistically significant (P<0.05). Conclusion In conclusion, the combination of TACE and RFA treatment had more advantages than LR, TACE and symptomatic treatments for PLC in improving survival rate and reducing costs.

Key words: Primary liver cancer, Survival rate, Cost-effectiveness

LIU Er-li, LI Bo-qun, HUANG Ying-ting, CUI Hao, WANG Xiao-jun, ZHANG Hong-ying. Cost-effectiveness comparison of four treatment strategies for primary liver cancer[J]. Chinese Hepatolgy, 2023, 28(2): 193-199.

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