PMID- 25682956
OWN - NLM
STAT- MEDLINE
DCOM- 20151123
LR  - 20150216
IS  - 1471-6348 (Electronic)
IS  - 0266-4623 (Linking)
VI  - 30
IP  - 4
DP  - 2014 Oct
TI  - Cost-effectiveness of navigated radiofrequency ablation for hepatocellular 
      carcinoma in China.
PG  - 400-8
LID - 10.1017/S0266462314000452 [doi]
AB  - OBJECTIVES: Real-time virtual sonography (RVS) is a promising navigation 
      technique for percutaneous radiofrequency ablation (RFA) treatment, especially in 
      ablating nodules poorly visualized on conventional ultrasonography (US). However, 
      its cost-effectiveness has not been established. The purpose of this study is to 
      evaluate the cost-effectiveness of RVS navigated RFA (RVS-RFA) relative to US 
      guided RFA (US-RFA) in patients with small hepatocellular carcinoma (HCC) in 
      China, from the modified societal perspective. METHODS: A state-transition Markov 
      model was created using TreeAge Pro 2012. The parameters used in the model, 
      including natural history of HCC patients, procedure efficacy and related costs, 
      were obtained from a systematic search of literature through PubMed, EMBASE, and 
      Science Citation Index databases. The simulated cohort was patients with 
      solitary, small HCC (<3 cm in diameter) and Child-Pugh class A or B, whose tumors 
      are poorly visualized in B-mode US but clearly detectable by CT or MRI. RESULTS: 
      In this cohort of difficult cases, RVS-RFA was a preferred strategy saving 2,467 
      CNY ($392) throughout the patient's life while gaining additional 1.4 QALYs 
      compared with conventional US guidance. The results were sensitive to the 
      efficacy of US-RFA and RVS-RFA including complete ablation rate and local 
      recurrence rate, the median survival for patients with progressive HCC, the 
      probability of performing RFA for recurrent HCC, and the cost of RVS navigation, 
      disposable needle or hospitalization. CONCLUSIONS: RVS-RFA is a dominant strategy 
      for patients with small HCC unidentifiable in B-mode US, in terms of cost savings 
      and QALYs gained, relative to the conventional US-guided method.
FAU - Lai, Yizhen
AU  - Lai Y
AD  - Harvard School of Public Health.
FAU - Li, Kai
AU  - Li K
AD  - The Third Affiliated Hospital of Sun Yat-sen University.
FAU - Li, Junbo
AU  - Li J
AD  - Philips Research Asia.
FAU - Liu, Sheena Xin
AU  - Liu SX
AD  - Philips Research North America,Briarcliff Manorxl2104@gmail.com.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Int J Technol Assess Health Care
JT  - International journal of technology assessment in health care
JID - 8508113
SB  - IM
MH  - Carcinoma, Hepatocellular/*surgery
MH  - Catheter Ablation/*economics/methods
MH  - China
MH  - Cost-Benefit Analysis
MH  - Humans
MH  - Liver Neoplasms/*surgery
MH  - Markov Chains
MH  - Quality-Adjusted Life Years
MH  - Technology Assessment, Biomedical
MH  - Ultrasonography, Interventional/*economics
OTO - NOTNLM
OT  - Markov model
EDAT- 2015/02/17 06:00
MHDA- 2015/12/15 06:00
CRDT- 2015/02/17 06:00
PHST- 2015/02/17 06:00 [entrez]
PHST- 2015/02/17 06:00 [pubmed]
PHST- 2015/12/15 06:00 [medline]
AID - S0266462314000452 [pii]
AID - 10.1017/S0266462314000452 [doi]
PST - ppublish
SO  - Int J Technol Assess Health Care. 2014 Oct;30(4):400-8. doi: 
      10.1017/S0266462314000452.