Radiofrequency Ablation Technology in Liver Malignancies: A Systematic Review of Economic Evaluations.

IF 1.6 Q4 ONCOLOGY

Journal of Gastrointestinal Cancer Pub Date : 2025-06-12 DOI:10.1007/s12029-025-01256-2

Amirreza Taherkhani, Hoornaz Molana, Mahsa Taremi, Ghader Mohammadnezhad

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引用次数: 0

Abstract

Background: Liver malignancies, including hepatocellular carcinoma (HCC), present significant treatment challenges, with limited curative options available. Radiofrequency ablation (RFA) has emerged as a minimally invasive therapeutic approach for early-stage HCC, offering comparable survival benefits to surgical resections in some patients. However, the economic implications of RFA relative to other treatment modalities remain a critical factor in decision-making. This study systematically reviews economic evaluations of RFA to assess its viability in managing liver malignancies.

Methods: A systematic review was conducted following the PRISMA guidelines. Databases, including PubMed, Scopus, Web of Science, and Google Scholar, were searched for economic evaluations of RFA published from 2015 onwards. Eligible studies compared RFA with other curative and palliative treatments, focusing on health-related economic outcomes. The primary outcome of the included studies was the incremental cost-effectiveness ratio (ICER).

Results: Ten studies met the inclusion criteria, covering diverse healthcare systems and cost-effectiveness models. The results indicated that RFA is generally more cost-effective than percutaneous ethanol injection [incremental cost: $ - 917, incremental effectiveness: 0.34, ICER: $ - 2675] and laparoscopic hepatectomy [incremental costs: ¥ - 4702, incremental effectiveness: 0] but less cost-effective than microwave ablation [ICER: dominated], liver resection, and transplantation [ICER: between $23,916 and $113,530/QALY] at higher willingness-to-pay thresholds. Comparisons with stereotactic body radiotherapy and surgery yielded mixed results.

Conclusions: RFA is a cost-effective treatment for small HCC tumors, particularly in resource-limited settings. However, its cost-effectiveness declines with increasing tumor size compared to liver transplantation. Further real-world economic evaluations and modeling studies are needed to confirm its affordability across different healthcare settings.

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射频消融术治疗肝脏恶性肿瘤：经济评价的系统综述。

背景：肝脏恶性肿瘤，包括肝细胞癌（HCC），目前具有显著的治疗挑战，治疗方案有限。射频消融（RFA）已成为早期HCC的微创治疗方法，在一些患者中提供与手术切除相当的生存益处。然而，相对于其他治疗方式，射频消融的经济影响仍然是决策的关键因素。本研究系统地回顾了RFA的经济评估，以评估其在治疗肝脏恶性肿瘤中的可行性。方法：按照PRISMA指南进行系统评价。检索了PubMed、Scopus、Web of Science和b谷歌Scholar等数据库，检索了2015年以来发表的RFA经济评价。符合条件的研究将RFA与其他治疗性和姑息性治疗进行了比较，重点关注与健康相关的经济结果。纳入研究的主要结局是增量成本-效果比（ICER）。结果：10项研究符合纳入标准，涵盖了不同的医疗体系和成本效益模型。结果表明，在较高的支付意愿阈值下，RFA总体上比经皮乙醇注射（增量成本：$ 917，增量有效性：0.34,ICER: $ 2675）和腹腔镜肝切除术（增量成本：$ 4702，增量有效性：0）更具成本效益，但比微波消融（ICER：占主导地位）、肝切除术和肝移植（ICER：在$23,916至$113,530/QALY之间）更具成本效益。与立体定向放射治疗和手术相比，结果好坏参半。结论：RFA是治疗小肝癌的一种经济有效的治疗方法，特别是在资源有限的地区。然而，与肝移植相比，其成本效益随着肿瘤大小的增加而下降。需要进一步的现实世界经济评估和建模研究来确认其在不同医疗保健环境中的可负担性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastrointestinal Cancer ONCOLOGY-

CiteScore

3.80

自引率

0.00%

发文量

121

期刊介绍： The Journal of Gastrointestinal Cancer is a multidisciplinary medium for the publication of novel research pertaining to cancers arising from the gastrointestinal tract.The journal is dedicated to the most rapid publication possible.The journal publishes papers in all relevant fields, emphasizing those studies that are helpful in understanding and treating cancers affecting the esophagus, stomach, liver, gallbladder and biliary tree, pancreas, small bowel, large bowel, rectum, and anus. In addition, the Journal of Gastrointestinal Cancer publishes basic and translational scientific information from studies providing insight into the etiology and progression of cancers affecting these organs. New insights are provided from diverse areas of research such as studies exploring pre-neoplastic states, risk factors, epidemiology, genetics, preclinical therapeutics, surgery, radiation therapy, novel medical therapeutics, clinical trials, and outcome studies.In addition to reports of original clinical and experimental studies, the journal also publishes: case reports, state-of-the-art reviews on topics of immediate interest or importance; invited articles analyzing particular areas of pancreatic research and knowledge; perspectives in which critical evaluation and conflicting opinions about current topics may be expressed; meeting highlights that summarize important points presented at recent meetings; abstracts of symposia and conferences; book reviews; hypotheses; Letters to the Editors; and other items of special interest, including:Complex Cases in GI Oncology: This is a new initiative to provide a forum to review and discuss the history and management of complex and involved gastrointestinal oncology cases. The format will be similar to a teaching case conference where a case vignette is presented and is followed by a series of questions and discussion points. A brief reference list supporting the points made in discussion would be expected.