Comparative analysis of medical costs after hepatectomy versus radiofrequency ablation in patients with hepatocellular carcinoma in real‐world clinical practice
Comparative analysis of medical costs after hepatectomy versus radiofrequency ablation in patients with hepatocellular carcinoma in real‐world clinical practice
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真实临床实践中肝细胞癌患者肝切除术与射频消融术后医疗费用的比较分析
DOI：
10.1111/hepr.13756
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发表时间：
2022
影响因子：
4.2
通讯作者：
Kaneko Shuichi
中科院分区：
文献类型：
--
作者：
Terashima Takeshi;Higashibeppu Yoichi;Yamashita Tatsuya;Sakata Yukinori;Azuma Mie;Munakata Hiroaki;Ishii Mika;Kaneko Shuichi
目的比较日本原发性肝细胞癌（HCC）患者初始治疗（即肝切除术或射频消融（RFA））的总医疗费用和治疗结果。方法采用医疗索赔数据库进行回顾性观察研究。接受肝切除术或RFA治疗原发性HCC的患者使用倾向评分匹配方法匹配可用的基线特征。估计了从初始治疗之日起至3年的平均每位患者总医疗费用。使用Kaplan - Meier方法估计3年生存率和复发率。结果共分析1726例患者资料，每组863例。RFA组的平均3年医疗费用比肝切除术组低8000美元（35000美元对43000美元）。RFA组患者的3年总生存率与肝切除术组相当（87.6% vs. 90.4%）。然而，RFA组的3年复发率明显高于肝切除术组（41.5% vs. 30.8%；风险比= 1.56,95%可信区间：1.31-1.87）。结论：在这项为期3年的研究中，无论初始治疗如何，患者的生存率相似，但RFA组的总医疗费用负担低于肝切除术组。如果两种治疗方法同样可行，RFA可能是原发性HCC的首选初始治疗方法。然而，由于其较高的复发风险，应慎重考虑并给予适当的治疗。
AimTo compare the total medical costs and treatment outcomes in patients with primary hepatocellular carcinoma (HCC) according to their initial treatment, that is, hepatectomy or radiofrequency ablation (RFA), in real‐world clinical practice in Japan.MethodsThis retrospective observational study was conducted using a medical claims database. Patients who underwent hepatectomy or RFA for primary HCC were matched using propensity score matching methods for available baseline characteristics. The average per‐patient total medical costs from the date of initial treatment to up to 3 years were estimated. The 3‐year survival and recurrence rates were estimated using the Kaplan‐Meier method.ResultsData of 1726 patients (863 in each group) were analyzed. The average 3‐year medical costs were USD 8000 lower in the RFA group than in the hepatectomy group (USD 35,000 vs. USD 43,000). Patients in the RFA group had comparable 3‐year overall survival to those in the hepatectomy group (87.6% vs. 90.4%). However, the 3‐year recurrence rate was significantly higher in the RFA group than in the hepatectomy group (41.5% vs. 30.8%; hazard ratio = 1.56, 95% confidence interval: 1.31–1.87).ConclusionsIn this 3‐year study, patients achieved similar survival rates irrespective of initial treatment, but the RFA group had a lower total medical cost burden than the hepatectomy group. If both treatments are equally feasible, RFA may be a preferable initial curative treatment for primary HCC. However, careful consideration and adequate treatment should be given due to its higher recurrence risk.
手术与射频消融治疗小肝细胞癌：随机对照试验（SURF 试验）的开始
影响因子：
4.2
作者：
K. Hasegawa;N. Kokudo;S. Shiina;R. Tateishi;M. Makuuchi
通讯作者：
M. Makuuchi