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Hepatocellular adenoma: cost-effectiveness of different treatment strategies.
- Source :
-
Radiology [Radiology] 2009 Sep; Vol. 252 (3), pp. 737-46. - Publication Year :
- 2009
-
Abstract
- Purpose: To determine the effectiveness, costs, and cost-effectiveness of strategies for the management of hepatocellular adenoma (HA) in women who are otherwise healthy.<br />Materials and Methods: A Markov model was developed to estimate the quality-adjusted life expectancy (in quality-adjusted life-years [QALYs]), lifetime costs (in 2007 U.S. dollars), and net health benefits (QALY equivalent) of surgery, transarterial embolization (TAE), radiofrequency ablation (RFA), and watchful waiting. Model parameters and their distributions were derived from the literature and the hospital database.<br />Results: In patients with HA tumors suitable for RFA, RFA had the highest effectiveness (23.89 QALYs) and lowest costs ($2965). The treatment decision was sensitive to RFA-related mortality. In patients with tumors unsuitable for RFA, watchful waiting combined with TAE in cases of hemorrhage had the highest effectiveness (23.83 QALYs) and lowest costs ($8493). The treatment decision was sensitive to probability of tumor growth, probability of hemorrhage, and hemorrhage-related mortality.<br />Conclusion: According to the model results, the most favorable treatment strategy for patients with small HAs was RFA. In patients with HA unsuitable for RFA, watchful waiting was the optimal strategy.
- Subjects :
- Adenoma economics
Cost-Benefit Analysis
Embolization, Therapeutic economics
Female
Humans
Length of Stay statistics & numerical data
Life Expectancy
Liver Neoplasms economics
Male
Markov Chains
Quality-Adjusted Life Years
Adenoma therapy
Catheter Ablation economics
Health Care Costs
Liver Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1527-1315
- Volume :
- 252
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Radiology
- Publication Type :
- Academic Journal
- Accession number :
- 19717753
- Full Text :
- https://doi.org/10.1148/radiol.2523082219