Cost-effectiveness of radiofrequency ablation versus percutaneous ethanol injection for early hepatocellular carcinoma in a resource-poor setting: a randomized trial

Autor: Guilherme Cayres Mariotti, Guilherme Eduardo Gonçalves Felga, Rodrigo Gobbo Garcia, Priscila Mina Falsarella, Bruno Pagnin Schmid, Daniel Tavares Malheiros, Ronaldo Hueb Baroni, Ary Serpa Neto
Jazyk: English<br />Portuguese
Rok vydání: 2024
Předmět:
Zdroj: Einstein (São Paulo), Vol 22 (2024)
Druh dokumentu: article
ISSN: 2317-6385
DOI: 10.31744/einstein_journal/2024gs0683
Popis: ABSTRACT Objective: This study assessed the cost-effectiveness of radiofrequency ablation compared with percutaneous ethanol injection in patients with early hepatocellular carcinoma in relation to the objective response rate and costs related to the procedure. Methods: This was a prospective single-center randomized trial. The primary outcome was cost-effectiveness. Secondary outcomes were the complete response rate according to the modified response evaluation criteria in solid tumors 60 days after randomization and the complication rate within 180 60 days. Results: Fifty patients were placed into the following groups: percutaneous ethanol injection (n=23) and radiofrequency ablation (n=27). Fifty-four nodules were randomized (mean follow-up: 205.37 days). The estimated mean hospital cost was US$ 1854.11 and US$ 2770.96 for the Radiofrequency Ablation and Percutaneous Ethanol Injection Groups, respectively. The incremental cost-effectiveness ratio was US$ -2674.59, which is advantageous for radiofrequency ablation. After 60 d, 28 of 29 nodules in the Radiofrequency Ablation Group achieved complete response versus 12 of 22 in the Percutaneous Ethanol Injection Group (RD, 42.01 [95%CI= 20.55–63.24]; p0.05), respectively. Conclusion: Radiofrequency ablation was more cost-effective and achieved higher complete response and lower complication rates than the Percutaneous Ethanol Injection Group within this cohort. Registry of Clinical Trials: NCT06450613
Databáze: Directory of Open Access Journals