Cost-effectiveness of whole-body bone scans in the pre-liver transplant assessment of patients with hepatocellular carcinoma in Southern Brazil

Autor:	Santiago Rodríguez, Ajácio Bandeira de Mello Brandão, Guillermo Kiss, Giácomo Balbinotto Neto
Rok vydání:	2016
Předmět:	Male medicine.medical_specialty Carcinoma Hepatocellular Cost effectiveness Cost-Benefit Analysis medicine.medical_treatment Liver transplantation Bone scans Gastroenterology Preoperative care 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Preoperative Care medicine Humans Whole Body Imaging In patient Retrospective Studies Transplantation business.industry Liver Neoplasms Retrospective cohort study Middle Aged Prognosis medicine.disease Liver Transplantation Surgery 030220 oncology & carcinogenesis Hepatocellular carcinoma Female 030211 gastroenterology & hepatology Neoplasm Recurrence Local business Whole body Brazil Follow-Up Studies
Zdroj:	Clinical Transplantation. 30:399-406
ISSN:	0902-0063
Popis:	Background Bone metastases (BM) are rare in patients with early-stage hepatocellular carcinoma (HCC). In many centers, liver transplantation (LTx) policies require patients with HCC to undergo bone scans (BSs). Methods We retrospectively assessed the benefit of BS for patients with a diagnosis of HCC wait-listed for LTx. Results BS was performed in 259 of 328 patients (78.9%) and was suggestive of BM in only one (0.4%). At follow-up, 276 patients had received LTx, of whom 207 had undergone BS. Histopathological examination of explants failed to confirm the presence of HCC in 20 patients from the BS group. The survival and recurrence rates of the 187 patients with confirmed HCC in the explant who underwent BS as part of pre-LTx assessment and 69 patients who did not undergo BS were compared. The one- and five-yr post-transplant survival rates were 81% and 69%, respectively, in the BS group vs. 78% and 62%, respectively, in patients who did not undergo BS (p = 0.25). The one- and five-yr post-LTx recurrence rates were 4.8% and 10.7%, respectively, in the BS group vs. 2.9% and 10.1%, respectively, in patients who did not undergo BS (p = 0.46). Conclusions BS generated expenditures of US$39 296 and was not cost-effective.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::dfe6d81fd10eb3502417db38b4da90a8 https://doi.org/10.1111/ctr.12699 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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