Colorectal cancer with liver metastasis is a potentially curable malignancy. Multidisciplinary treatment including hepatic tumor resection provides 20-40% 5 year survival rate. However, the utility of hepatic resection for liver metastases in colorectal cancer is still debatable. Liver metastasectomy requires specialized centers having expertise, resources, and awareness which consume significant amount of hospital budgets. We aimed to evaluate the cost-effectiveness of hepatic metastasectomy in patients with advanced colon cancer with liver metastasis.
Medical records of advanced colon cancer patients with liver metastasis only who treated at the King Chulalongkorn Memorial Hospital during January 2007 to 31 December 2010 were reviewed. The study endpoint is to compare the cost per life-year gained in term of incremental cost-effectiveness ratio (ICER) between with or without hepatic metastasectomy by the decision model. Data regarding site of primary tumor, characteristics of liver metastases, treatment strategies, chemotherapy regimens, biologic agents, complications, health coverage and survival data were collected and analyzed.
There were 34 patients in liver surgery group and 28 patients in without surgery group. There was significantly longer median survival time in the surgery group vs no surgery, 42.22 vs 18.04 months, respectively (HR = 23.3, P
Under the routine clinical service, hepatic metastasectomy is a cost-effective option for patients with colon cancer with liver only metastasis in the tertiary care hospital setting.
Clinical trial identification
Legal entity responsible for the study
Medical Oncology Department, Faculty of Medicine, Chulalongkorn University
All authors have declared no conflicts of interest.