日本四期结直肠癌术后监测的成本-效果分析:一项经济模型研究

IF 3.3 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Fumio Tsukamoto, Shunsuke Tsukamoto, Takeharu Kato, Hiroshi Nagata, Yasuyuki Takamizawa, Konosuke Moritani, Yusuke Kinugasa, Minoru Esaki, Yukihide Kanemitsu, Ataru Igarashi
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引用次数: 0

摘要

背景IV期结直肠癌根治性切除后最佳的术后监测策略尚不清楚。本研究旨在评估各种学术协会推荐的IV期结直肠癌根治切除后术后监测策略的成本效益。方法采用马尔科夫状态转移模型进行经济评估,比较美国临床肿瘤学会、美国结肠直肠外科学会、欧洲肿瘤医学学会、国家综合癌症网络和日本结肠直肠癌症学会发布的指南中提出的术后监测方案的成本效益。模型参数是从我们的回顾性数据中提取的,这些数据来自于同时发生肝和/或肺转移并接受根治性切除的结直肠癌患者。使用质量调整寿命年的增量成本效益比评估成本效益,可接受的最大值为5 000 - 6 000 000日元/33333 - 4万美元。模型的不确定性通过概率敏感性分析进行评估。结果对于治愈性切除的IV期结直肠癌患者,jsccr策略是最具成本效益的,与第二具成本效益的方案相比,增量成本-效果比为2 888 628日元/19256美元。概率敏感性分析显示,jsccr -策略最有可能被选择为最具成本效益(76.1% ~ 77.9%)。该模型分析发现,jsccr策略是IV期结直肠癌最具成本效益的策略。我们的研究结果表明,对IV期结直肠癌进行术后强化监测是可以接受的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Cost-effectiveness analysis of postoperative surveillance for stage IV colorectal cancer in Japan: An economic modeling study

Cost-effectiveness analysis of postoperative surveillance for stage IV colorectal cancer in Japan: An economic modeling study

Background

The optimal postoperative surveillance strategy after curative resection in patients with stage IV colorectal cancer remains unclear. The present study aimed to assess the cost-effectiveness of postoperative surveillance strategies recommended by the various academic societies for stage IV colorectal cancer after curative resection.

Methods

This economic evaluation used a Markov state-transition model to compare the cost-effectiveness of postoperative surveillance programs proposed in guidelines published by the American Society of Clinical Oncology, American Society of Colon and Rectal Surgeons, European Society for Medical Oncology, National Comprehensive Cancer Network, and Japanese Society for Cancer of the Colon and Rectum. Model parameters were extracted from our retrospective data for patients with colorectal cancer who had synchronous liver and/or lung metastases and underwent curative resection. Cost-effectiveness was assessed using an incremental cost-effectiveness ratio for quality-adjusted life years, with a maximum acceptable value of 5 000 000–6 000 000 JPY/33333–40 000 USD. Uncertainty in the model was assessed by probabilistic sensitivity analyses.

Results

For patients with stage IV colorectal cancer after curative resection, the JSCCR-strategy was the most cost-effective, with an incremental cost-effectiveness ratio of 2 888 628 JPY/19256 USD compared with the next most cost-effective program. Probabilistic sensitivity analysis showed that the JSCCR-strategy was most likely to be selected as the most cost-effective (76.1%–77.9%).

Conclusions

This modeling analysis found that the JSCCR-strategy was the most cost-effective strategy for stage IV colorectal cancer. Our findings suggest that intensive postoperative surveillance is acceptable for stage IV colorectal cancer.

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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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