射频消融加上与乙型肝炎病毒相关的肝细胞癌类似的核苷酸

StephenW

Am J Transl Res. 2018 Aug 15;10(8):2685-2695. eCollection 2018.
Radiofrequency ablation plus nucleotide analogous for hepatitis B virus-related hepatocellular carcinoma: a cost-effectiveness analysis.
Liu B1, Wei M2, Liu F2, Chen S1, Peng Z3, Li B4, Zhou Q4, Wang H4, Peng S4,5, Kuang M1,2.
Author information

1
    Division of Interventional Ultrasound, The First Affiliated Hospital, Sun Yat-Sen University Guangzhou 510080, China.
2
    Department of Liver Surgery, The First Affiliated Hospital, Sun Yat-Sen University Guangzhou 510080, China.
3
    Department of Oncology, The First Affiliated Hospital, Sun Yat-Sen University Guangzhou 510080, China.
4
    Clinical Research Unit, The First Affiliated Hospital, Sun Yat-Sen University Guangzhou 510080, China.
5
    Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Sun Yat-Sen University Guangzhou 510080, China.

Abstract

In the real-world, it is unclear that after the radiofrequency ablation (RFA), whether it is a cost-effective strategy to administer nucleotide analogue (NA) for patients with hepatitis B virus (HBV)-related HCC patients. The aim of this study was to estimate the cost-effectiveness of the RFA plus NA versus RFA alone in patients with HBV-related HCC within the Milan criteria in China and the USA. A Markov model was developed to simulate a cohort of patients with HCC within the Milan criteria and Child-Pugh A/B cirrhosis and underwent RFA with or without NA therapy over their remaining life expectancy. Analysis was performed in two geographical cost settings: China and the USA. The RFA plus NA therapy provided an average of 7.57 years, whereas RFA monotherapy offered 5.83 years. The RFA plus NA therapy produced 5.09 quality-adjusted life years (QALYs), whereas RFA monotherapy achieved 3.89 QALYs. The incremental cost-effectiveness ratio (ICER) of the RFA plus NA therapy versus RFA monotherapy was $10368.19/QALY in China and $38805.45/QALY in the USA. These values were below the thresholds of the cost-effectiveness in both countries. Sensitivity analysis revealed that the utility of recurrent HCC was the most sensitive parameter in all cost scenarios in both of the RFA plus NA therapy and RFA monotherapy groups. Our Markov model has shown that for the patients with HBV-related HCC within the Milan criteria and Child-Pugh A/B cirrhosis, RFA plus NA is more cost-effective than RFA monotherapy across the two different cost scenarios namely, China and the USA.
KEYWORDS:

Hepatocellular carcinoma; Markov model; nucleotide analogous; radiofrequency ablation

PMID:
    30210705

StephenW

Am J Transl Res。 2018年8月15日; 10（8）：2685-2695。 eCollection 2018。
射频消融加上与乙型肝炎病毒相关的肝细胞癌类似的核苷酸：成本效益分析。
Liu B1，Wei M2，Liu F2，Chen S1，Peng Z3，Li B4，Zhou Q4，Wang H4，Peng S4,5，Kuang M1,2。
作者信息

1
    中山大学附属第一医院介入超声科，广州510080
2
    中山大学附属第一医院肝外科广州510080
3
    中山大学附属第一医院肿瘤科，广州510080
4
    中山大学附属第一医院临床研究室，广州510080
五
    中山大学附属第一医院消化内科，广东广州510080

抽象

在现实世界中，目前尚不清楚射频消融（RFA）后，对于乙型肝炎病毒（HBV）相关的HCC患者，是否采用经济有效的策略来管理核苷酸类似物（NA）。本研究的目的是在中国和美国的米兰标准中评估RFA加NA与单独RFA在HBV相关HCC患者中的成本效益。开发马尔可夫模型以模拟在米兰标准和Child-Pugh A / B肝硬化期间的一组HCC患者，并且在他们的剩余预期寿命期间接受或不接受NA治疗的RFA。分析在两个地理成本设置中进行：中国和美国。 RFA加NA治疗平均提供7。57年，而RFA单药治疗提供5.83岁。 RFA加NA治疗产生5.09质量调整生命年（QALYs），而RFA单药治疗达到3.89 QALYs。 RFA加NA治疗与RFA单药治疗的增量成本效益比（ICER）在中国为10368.19美元/ QALY，在美国为38805.45美元/ QALY。这些数值低于两国成本效益的阈值。敏感性分析显示，在RFA加NA治疗和RFA单药治疗组的所有成本情景中，复发性HCC的效用是最敏感的参数。我们的马尔可夫模型显示，对于符合米兰标准和Child-Pugh A / B肝硬化的HBV相关HCC患者，RFA加NA在两种不同的成本情况下，即中国和美国，比RFA单药治疗更具成本效益。
关键词：

肝细胞癌;马尔可夫模型;核苷酸类似;射频消融术

结论：
    30210705