多次减瘤手术联合腹腔内热灌注化疗治疗腹膜转移癌的成本效果分析。
Cost-effectiveness of Iterative Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy for the Treatment of Peritoneal Carcinomatosis.
机构信息
Department of Surgery, University of New South Wales, St. George Hospital, Sydney, NSW, Australia;
Department of Surgery, University of New South Wales, St. George Hospital, Sydney, NSW, Australia.
出版信息
In Vivo. 2022 May-Jun;36(3):1527-1533. doi: 10.21873/invivo.12863.
BACKGROUND
Iterative cytoreduction (iCRS) and hyperthermic intraperitoneal chemotherapy is a treatment for recurrence of peritoneal carcinomatosis. There are considerable upfront costs for this approach for which the cost-effectiveness has not been evaluated.
PATIENTS AND METHODS
We used a prospectively maintained database of patients having undergone primary and iterative cytoreduction at St. George Hospital between January 1, 2014, and December 31, 2017, which was linked with financial data. Cost effectiveness and survival outcomes were used to compare primary cytoreduction (pCRS) and iterative cytoreduction (iCRS) in addition to comparison with other treatment modalities.
RESULTS
The average cost per patient in Australian dollars was $69,295 ($14,691-$696,002) and the average cost per life-year was $15,842. There was no difference in cost-effectiveness between those who had undergone pCRS and those who had undergone iCRS. The overall survival was 52.5 months (95% confidence interval=49.7-55.2 months) with no difference in survival between pCRS and iCRS groups. The median length of hospital stay was significantly longer for patients in the pCRS treatment group (25.51 days) when compared to the iCRS treatment group (21.15 days, p=0.034).
CONCLUSION
iCRS is a cost-effective treatment in the management of recurrent peritoneal carcinomatosis.
背景
反复细胞减灭术（iCRS）和腹腔内热化疗是治疗腹膜癌复发的一种方法。这种方法需要大量的前期投入，但其成本效益尚未得到评估。
患者和方法
我们使用了圣乔治医院 2014 年 1 月 1 日至 2017 年 12 月 31 日期间接受初次和反复细胞减灭术的患者的前瞻性维护数据库，并与财务数据相关联。我们比较了初次细胞减灭术（pCRS）和反复细胞减灭术（iCRS）的成本效益和生存结果，此外还与其他治疗方式进行了比较。
结果
每位患者的平均澳元成本为 69295 澳元（14691 澳元至 696002 澳元），平均每生命年成本为 15842 澳元。pCRS 和 iCRS 患者的成本效益没有差异。总生存率为 52.5 个月（95%置信区间为 49.7-55.2 个月），pCRS 和 iCRS 组之间的生存率无差异。初次细胞减灭术治疗组的患者住院时间中位数明显长于反复细胞减灭术治疗组（25.51 天比 21.15 天，p=0.034）。
结论
iCRS 是治疗腹膜癌复发的一种具有成本效益的治疗方法。
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